Provider Demographics
NPI:1215087440
Name:PALMATEER, NADINE SMITH (MA)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:SMITH
Last Name:PALMATEER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:FRANCES
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3099 RIVER RD S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9754
Mailing Address - Country:US
Mailing Address - Phone:503-485-2581
Mailing Address - Fax:503-485-2564
Practice Address - Street 1:3099 RIVER RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:503-485-2581
Practice Address - Fax:503-485-2564
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20591231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR110700Medicaid