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1134970130
AIDAN S SORRELLS
SALEM, OR
NPI
1134970130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-03-28
Last Update Date
2024-03-28
Business Address
AIDAN S SORRELLS PSS
863 LIBERTY ST NE
SALEM, OR 97301-2451
Phone number: 877-522-1275
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Mailing Address
AIDAN S SORRELLS PSS
5615 DUNBARTON AVE
PASCO, WA 99301-8216
Phone number: 877-522-1275
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