Healthcare Provider Details
I. General information
NPI: 1194640896
Provider Name (Legal Business Name): CORTNIE CIULLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 RIVER RD
EUGENE OR
97404-3212
US
IV. Provider business mailing address
1170 LINN WAY UNIT A
BROWNSVILLE OR
97327-2116
US
V. Phone/Fax
- Phone: 541-713-2611
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: