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Individual

SUNAN R WATERS SUTTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
104 E VIRGINIA ST, STAYTON, OR 97383-1751
(503) 769-3384
Mailing address
104 E VIRGINIA ST, STAYTON, OR 97383-1751
(503) 769-3384

Taxonomy

Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
261066
OR

Other

Enumeration date
03/25/2009
Last updated
03/25/2009
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