Healthcare Provider Details

I. General information

NPI: 1548173719
Provider Name (Legal Business Name): MARY ANGEL ARTUNYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4666 COMMERCIAL ST SE
SALEM OR
97302-1902
US

IV. Provider business mailing address

5731 ERIN VALLEY AVE SE
SALEM OR
97306-1910
US

V. Phone/Fax

Practice location:
  • Phone: 503-851-7735
  • Fax:
Mailing address:
  • Phone: 503-851-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29911
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: