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Individual

MS. DIONNE ELAINE ELLERBROOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3025 SW RESERVOIR RD, REDMOND, OR 97756-9481
(541) 548-5066
Mailing address
798 NW 28TH LOOP, REDMOND, OR 97756-7212
(503) 740-0100

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200830485LPN
OR

Other

Enumeration date
11/08/2009
Last updated
11/08/2009
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