Individual
DAN EASDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2311 NW VAN BUREN AVE APT 5, CORVALLIS, OR 97330-5393
(541) 224-1170
Mailing address
2311 NW VAN BUREN AVE APT 5, CORVALLIS, OR 97330-5393
(541) 224-1170
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000107037
OR
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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