Individual
DANIELLE MATELESKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 THOMPSON ST, HEPPNER, OR 97836-7325
(541) 676-5504
Mailing address
120 S HAYES AVE APT A, POCATELLO, ID 83204-4941
(401) 744-1595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA192323
OR
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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