Most Relevant Information
Provider Data
| NPI Number: | 1003359605 |
| Provider Name: | ANGELA ROSE RICHARD |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/30/2016 |
| Last Updated: | 11/30/2016 |
Provider Practice Location
3410 CHERRY AVENUE NE
KEIZER
OR
97303
Practice Location Phone/Fax
| Phone: | 5033043400 |
| Fax: |
Provider Mailing Location
2445 ADAMS ST SE
SALEM
OR
97301
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |