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General NPI Number Information
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NPI Number | 1588203749
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Entity Type | Individual
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Provider Name | SALA A AYITEY DNP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2020
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 913 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-6523
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Country | US
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Telephone | 541-607-0897
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Fax | 541-607-7573
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Provider Business Mailing Address
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Address Line | 913 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-6523
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Country | US
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Telephone |
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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 | 95013541
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License Number State | CA
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