Provider Demographics
NPI:1447664446
Name:DANNEN, MARIVEL
Entity type:Individual
Prefix:
First Name:MARIVEL
Middle Name:
Last Name:DANNEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 METHODIST RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7712
Mailing Address - Country:US
Mailing Address - Phone:541-603-3799
Mailing Address - Fax:
Practice Address - Street 1:971 METHODIST RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-7712
Practice Address - Country:US
Practice Address - Phone:541-603-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR098000234RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse