Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A12978 | CA |
Y | 207Q00000X | Family Doctor | DO172301 | OR |
NPI | 1003162959 |
---|---|
Provider Name | Dr. Amy Lynne Card |
First Address | Salem, OR 97306-9490 |
Second Address | Salem, OR 97306-9490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2012 |
Last Update Date | 19/08/2021 |