Individual
WILSON PAUL KISAMBIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 COMMERCIAL ST SE # APPT515, SALEM, OR 97301-3484
(781) 309-8976
Mailing address
315 COMMERCIAL ST SE # APPT515, SALEM, OR 97301-3484
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10018221
OR
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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