Individual
DANIEL NOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1258 HIGH ST, EUGENE, OR 97401-3238
(541) 554-5746
Mailing address
3555 GATEWAY ST STE 101, SPRINGFIELD, OR 97477-1083
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THW000105771
—
OR
Enumeration date
12/09/2021
Last updated
10/11/2023
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