Individual
JODI LEANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4760 PORTLAND RD NE, SALEM, OR 97305-1760
(503) 949-1387
Mailing address
16445 MUSTANG LN NE, SILVERTON, OR 97381-2528
(503) 949-1387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200243022RN
OR
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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