Individual
JEANNINE DENIECE DEAVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4909 S COAST HWY STE 1, SOUTH BEACH, OR 97366-9667
(541) 574-5960
(541) 265-0601
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0581
(541) 574-6252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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