Individual
ELENA PICENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-0635
Mailing address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-0635
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000108253
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW00018253
OREGON HEALTH AUTHORITY
OR
Enumeration date
02/08/2023
Last updated
02/08/2023
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