KOURTNEY RAVEN DENINO

ROSEBURG, OR
NPI1841868015
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR  201406969LPN)
Enumeration Date2021-06-15
Last Update Date2021-06-15
Business Address
KOURTNEY RAVEN DENINO
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
Mailing Address
KOURTNEY RAVEN DENINO
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691