Healthcare Provider Details

I. General information

NPI: 1528126992
Provider Name (Legal Business Name): MRS. ROSIE P SALIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 1ST ST
PHOENIX OR
97535-9787
US

IV. Provider business mailing address

701 1ST ST
PHOENIX OR
97535-9787
US

V. Phone/Fax

Practice location:
  • Phone: 541-535-6308
  • Fax:
Mailing address:
  • Phone: 541-535-6308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1513-570395-0705-COM
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: