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General NPI Number Information
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NPI Number | 1255678165
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Entity Type | Organization
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Legal Business Name | WILLAMETTE SLEEP SOLUTIONS LLC
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Dates
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Enumeration Date | 01/11/2013
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 3099 RIVER RD S SUITE 250
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City | SALEM
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State | OR
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Zip | 97302-9754
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Country | US
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Telephone | 503-485-2578
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Fax | 503-485-2590
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Provider Business Mailing Address
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Address Line | 3099 RIVER RD S SUITE 250
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City | SALEM
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State | OR
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Zip | 97302-9754
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Country | US
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Telephone | 503-485-2578
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Fax | 503-485-2590
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Authorized Official
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Title or Position | DIRECTOR OF DENTAL SLEEP MEDICINE
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Name | DR. NAHMJEE LEE SKARADA
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Credential | DMD
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Telephone | 503-485-2578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D8837
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License Number State | OR
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