Healthcare Provider Details

I. General information

NPI: 1477857118
Provider Name (Legal Business Name): HOLLY ANN SAULIE-ROHMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NW 27TH ST
CORVALLIS OR
97339
US

IV. Provider business mailing address

115 NW 11TH ST
CORVALLIS OR
97330-6004
US

V. Phone/Fax

Practice location:
  • Phone: 541-766-6134
  • Fax:
Mailing address:
  • Phone: 360-766-6134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number200841442RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: