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Individual

MS. TRENDA RENEE CORNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1445 ARATA WAY, ONTARIO, OR 97914-4505
(458) 224-1045
Mailing address
1445 ARATA WAY, ONTARIO, OR 97914-4505
(458) 224-1045

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
519242
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500809241
OR
Enumeration date
09/07/2022
Last updated
09/07/2022
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