Individual
ISHAWN LEVETTE EALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2421 LANCASTER DR NE, SALEM, OR 97305-1220
(503) 585-4910
(503) 361-2782
Mailing address
4549 AGATE DR SE, SALEM, OR 97317
(503) 871-4346
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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