Provider Demographics
NPI:1598520850
Name:DELGADO FERREYRA, ROSAISELA
Entity Type:Individual
Prefix:
First Name:ROSAISELA
Middle Name:
Last Name:DELGADO FERREYRA
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 1:1401 MADRONA LN
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-3145
Mailing Address - Country:US
Mailing Address - Phone:971-217-2748
Mailing Address - Fax:
Practice Address - Street 1:2030 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-3049
Practice Address - Country:US
Practice Address - Phone:971-217-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist