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NPI Code Detail

MEDICARE: DANIELLE LEE NEIS

MEDICARE: DANIELLE LEE NEIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorT-25-6140OR

General Provider Information

NPI Number : 1609702216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE LEE NEIS
Provider Business Mailing Address
First Line : 2142 N KEENE WAY DR APT 5
Second Line :
City : MEDFORD
State : OR
Zip : 97504-1801
Country : US
Telephone Number : 541-816-6396
Fax Number :
Provider Business Practice Location Address
First Line : 3397 DELTA WATERS RD
Second Line :
City : MEDFORD
State : OR
Zip : 97504-5852
Country : US
Telephone Number : 541-772-4648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ DANIELLE LEE NEIS ” Practice Location

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