Individual
MS. MICHELLE LYNN LASETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
290 MOYER LN. NW, SALEM, OR 97304
(503) 485-2197
(503) 363-4214
Mailing address
290 MOYER LN. NW, SALEM, OR 97304
(503) 485-2197
(503) 363-4214
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039714
—
OR
Enumeration date
06/22/2009
Last updated
06/22/2009
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