Individual
SHAY DEAN LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCMA
Contact information
Practice address
4077 SW RESEARCH WAY, CORVALLIS, OR 97333-1065
(541) 766-6190
(541) 766-6164
Mailing address
1420 MEADOWLARK LN, SWEET HOME, OR 97386-1310
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
962516
NCCT
OR
Enumeration date
10/08/2020
Last updated
10/10/2020
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