Ellis, Danielle Promise

Ellis, Danielle Promise is an sole proprietor health care provider with primary practice located at 557 Nw Monroe Ave , Corvallis OR 97330-4721. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Ellis, Danielle Promise can be contacted via phone (541) 766-3540.

Contact Information

Primary practice address
557 Nw Monroe Ave Corvallis OR 97330-4721
Phone: (541) 766-3540
Fax: (541) 766-3543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 18-01-44 Oregon

Profile Details

NPI number 1275098899
LBN Legal business name Ellis, Danielle Promise
Credentials AS, CADC I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2019
Last updated Feb 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275098899 NPPES
Oregon MEDICAID 18-01-44
Oregon Other 18-01-44

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