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1710134861
MICHELLE R EIDE
MOLALLA, OR
NPI
1710134861
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: OR 14804)
Enumeration Date
2008-08-20
Last Update Date
2008-08-20
Business Address
Mrs. MICHELLE R EIDE LMT
683 JUNE DR
MOLALLA, OR 97038-9281
Phone number: 503-351-7896
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Mailing Address
Mrs. MICHELLE R EIDE LMT
683 JUNE DR
MOLALLA, OR 97038-9281
Phone number: 503-351-7896
Copy