Individual
SHELAINE M QUALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 326-4905
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 326-4905
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
17-CRM-224
OR
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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