LISA DAWN THEOBALD

SALEM, OR
NPI1366136228
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR  10006245)
Enumeration Date2023-06-05
Last Update Date2024-03-13
Business Address
LISA DAWN THEOBALD PMHNP
2264 MCGILCHRIST ST SE STE 100
SALEM, OR 97302-1008
Phone number: 503-930-1812
Mailing Address
LISA DAWN THEOBALD PMHNP
2264 MCGILCHRIST ST SE STE 100
SALEM, OR 97302-1008
Phone number: