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General NPI Number Information
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NPI Number | 1144540436
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Entity Type | Individual
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Provider Name | CHRIS ADAM KLERONOMOS DAOM, FNP
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Gender | Male
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 700 BELLEVUE ST SE #225
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City | SALEM
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State | OR
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Zip | 97301-3819
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Country | US
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Telephone | 971-273-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 700 BELLEVUE ST SE #225
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City | SALEM
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State | OR
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Zip | 97301-3819
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Country | US
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Telephone | 971-273-0070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201050042NP
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License Number State | OR
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