Provider Demographics
NPI:1578006235
Name:PEET, D'LEENE (RN)
Entity Type:Individual
Prefix:
First Name:D'LEENE
Middle Name:
Last Name:PEET
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:D'LEENE
Other - Middle Name:
Other - Last Name:LEAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97114-9757
Mailing Address - Country:US
Mailing Address - Phone:503-560-3001
Mailing Address - Fax:
Practice Address - Street 1:515 1ST ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OR
Practice Address - Zip Code:97114-9757
Practice Address - Country:US
Practice Address - Phone:503-560-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201390181RN163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency