Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 201505393NP-PP | OR |
NPI | 1104200799 |
---|---|
Provider Name | Mrs. Devin A. Salazar |
First Address | Woodburn, OR 97071 |
Second Address | Silverton, OR 97381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2015 |
Last Update Date | 21/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201505393NP-PP | OREGON LICENSE (01) | OR |
500690940 | (05) | OR |