Individual
DANIELLE CHERIE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
718 N MAIN AVE, GRESHAM, OR 97030-7229
(971) 666-7795
Mailing address
718 N MAIN AVE, GRESHAM, OR 97030-7229
(971) 666-7795
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10170832
OR
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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