Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 6657 | OR |
NPI | 1629147400 |
---|---|
Provider Name | Dr. Paula Lorene Eschtruth |
First Address | Salem, OR 97304 |
Second Address | Salem, OR 97304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |