Organization
CARRIE DISTEFANO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE DISTEFANO IBCLC (OWNER)
(458) 225-0247
Entity
Organization
Contact information
Practice address
425 SHERIDAN ST, ASHLAND, OR 97520-1525
(458) 225-0247
Mailing address
425 SHERIDAN ST, ASHLAND, OR 97520-1525
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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