Provider Demographics
NPI:1528618659
Name:PIERCE, LINDA DIANE
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:DIANE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12098
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-0098
Mailing Address - Country:US
Mailing Address - Phone:503-362-5918
Mailing Address - Fax:
Practice Address - Street 1:1724 BROADWAY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0509
Practice Address - Country:US
Practice Address - Phone:503-391-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator