Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | OR |
NPI | 1093818353 |
---|---|
Provider Name | Ms. Sheri L Gray |
First Address | Salem, OR 97304-9509 |
Second Address | Salem, OR 97305-9427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |