MEDICARE: DEVIN SELLERS

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1699553990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVIN SELLERS

Provider Business Mailing Address
First Line	:	2449 LOS ANGELES AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-8687
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2449 LOS ANGELES AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-8687
Country	:	US
Telephone Number	:	503-781-5899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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Directions to “ DEVIN SELLERS ” Practice Location

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