Healthcare Provider Details

I. General information

NPI: 1336552124
Provider Name (Legal Business Name): NANCY SNIDER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1599 STATE ST
SALEM OR
97301-4255
US

IV. Provider business mailing address

1599 STATE ST
SALEM OR
97301-4255
US

V. Phone/Fax

Practice location:
  • Phone: 503-363-3260
  • Fax: 503-585-0491
Mailing address:
  • Phone: 503-363-3260
  • Fax: 503-585-0491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: