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Individual

DEANNA L ELLINGSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
283 SE FOWLER ST STE 2, ROSEBURG, OR 97470-3309
(541) 464-6455
(541) 464-6457
Mailing address
283 SE FOWLER ST STE 2, ROSEBURG, OR 97470-3309

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
06/06/2022
Last updated
06/06/2022
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