Individual
KELLIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA, EFDA
Contact information
Practice address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313
(503) 375-5737
Mailing address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313
(503) 375-5737
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
120376
OR
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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