Individual
KODY AUSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 585-4949
Mailing address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 585-4949
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
936002307
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122994
—
OR
Enumeration date
07/25/2024
Last updated
07/25/2024
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