Provider Demographics
NPI:1407637770
Name:CURTISS, CAELEN ALEXANDER
Entity Type:Individual
Prefix:
First Name:CAELEN
Middle Name:ALEXANDER
Last Name:CURTISS
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 1:2409 MOUNT HOOD ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-1220
Mailing Address - Country:US
Mailing Address - Phone:541-705-5475
Mailing Address - Fax:
Practice Address - Street 1:2012 E 14TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3974
Practice Address - Country:US
Practice Address - Phone:541-705-5475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator