Healthcare Provider Details

I. General information

NPI: 1922215698
Provider Name (Legal Business Name): ELLEN G. FRICHETTE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 NE FORD ST
MCMINNVILLE OR
97128-3634
US

IV. Provider business mailing address

1339 NE FORD ST
MCMINNVILLE OR
97128-3634
US

V. Phone/Fax

Practice location:
  • Phone: 971-241-4849
  • Fax:
Mailing address:
  • Phone: 971-241-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: