Individual
SHAREESE DANIELLE KILBANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 N POLK ST, EUGENE, OR 97402-7102
(541) 510-2535
Mailing address
311 N POLK ST, EUGENE, OR 97402-7102
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
000105027
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000105027
THW
OR
Enumeration date
07/15/2021
Last updated
07/15/2021
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