Individual
MARISSA ORTEGA COLANGELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2315 11TH ST, NORTH BEND, OR 97459-2102
(916) 402-0743
Mailing address
2315 11TH ST, NORTH BEND, OR 97459-2102
(916) 402-0743
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201902800RN
OR
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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