Individual
MELISSA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 MARKET ST NE STE 530, SALEM, OR 97301-1835
(503) 390-5637
Mailing address
614 MARIA AVE W, MONMOUTH, OR 97361-1016
(503) 586-4630
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/29/2007
Last updated
09/29/2007
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