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General NPI Number Information
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NPI Number | 1619281623
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Entity Type | Individual
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Provider Name | OLESYA SALATHE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 106 E 2ND ST
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City | MOLALLA
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State | OR
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Zip | 97038-9195
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Country | US
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Telephone | 503-829-9731
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Fax | 503-829-8626
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Provider Business Mailing Address
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Address Line | PO BOX 657
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City | MOLALLA
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State | OR
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Zip | 97038-0657
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D9476
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License Number State | OR
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