Individual
MRS. DANIELLE LEYLA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19723 S HWY 213, OREGON CITY, OR 97045-4190
(503) 656-9030
(503) 656-9026
Mailing address
728 MOLALLA AVE, SUITE AB, OREGON CITY, OR 97045
(503) 656-9030
(503) 656-9026
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200150108NP
OR
363L00000X
Nurse Practitioner
200150108NPFNPPP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262804
—
OR
Enumeration date
05/02/2006
Last updated
06/05/2015
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