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General NPI Number Information
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NPI Number | 1952818213
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Entity Type | Individual
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Provider Name | MR. JOSHUA KLINGE
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Gender | Male
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 185 13TH ST NE
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City | SALEM
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State | OR
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Zip | 97301-4116
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Country | US
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Telephone | 503-881-9157
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Fax | 503-362-3939
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Provider Business Mailing Address
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Address Line | 185 13TH ST NE
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City | SALEM
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State | OR
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Zip | 97301-4116
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Country | US
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Telephone | 503-881-9157
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Fax | 503-362-3939
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 78412
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License Number State | OR
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