Provider Demographics
NPI:1598127532
Name:ROWE, PAULA MARIE
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:ROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:GRANNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 12TH ST CUTOFF SE APT 12
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1875
Mailing Address - Country:US
Mailing Address - Phone:503-931-1875
Mailing Address - Fax:
Practice Address - Street 1:4001 12TH ST CUTOFF SE
Practice Address - Street 2:APT 11
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1770
Practice Address - Country:US
Practice Address - Phone:503-931-1875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker