Individual
DAPHNE TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
547 KNAPP PL NE, SALEM, OR 97301-2443
(971) 240-0199
Mailing address
547 KNAPP PL NE, SALEM, OR 97301-2443
(971) 240-0199
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
097003182LPN
OR
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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