Individual
SUSANA PELAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4275 COMMERCIAL ST SE STE 180, SALEM, OR 97302-4087
(503) 983-3348
Mailing address
4275 COMMERCIAL ST SE STE 180, SALEM, OR 97302-4087
(503) 983-3348
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6233874
OREGON ID
OR
Enumeration date
02/04/2019
Last updated
02/04/2019
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