Provider Demographics
NPI:1174064893
Name:ARNOLD, CANDACE MICHELLE (PSS)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:MICHELLE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 SKYLINE WAY S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2002
Mailing Address - Country:US
Mailing Address - Phone:503-983-3348
Mailing Address - Fax:503-390-3161
Practice Address - Street 1:1300 BROADWAY ST NE
Practice Address - Street 2:SUITE 403
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1420
Practice Address - Country:US
Practice Address - Phone:503-363-8068
Practice Address - Fax:503-390-3161
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist