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1497251151
RAUL BERNARDO DIESTRA
SALEM, OR
NPI
1497251151
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2018-04-02
Last Update Date
2018-04-04
Business Address
RAUL BERNARDO DIESTRA
1118 OAK ST SE
SALEM, OR 97301-4019
Phone number: 503-358-4850
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Mailing Address
RAUL BERNARDO DIESTRA
1118 OAK ST SE
SALEM, OR 97301-4019
Phone number:
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