Etzel, Fara Katrina
Etzel, Fara Katrina is an individual health care provider with primary practice located at 2395 Center St Ne , Salem OR 97301-4464. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Etzel, Fara Katrina can be contacted via phone (503) 364-2181.Contact Information
Primary practice address
2395 Center St Ne
Salem OR 97301-4464
Phone: (503) 364-2181
Fax: (503) 364-0364
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD23500 | Oregon |
Profile Details
| NPI number | 1770525263 |
|---|---|
| LBN Legal business name | Etzel, Fara Katrina |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770525263 | NPPES |
| Oregon | MEDICAID | 182833 |
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