Provider Demographics
NPI:1881464782
Name:MCCHESNEY, ELLEN MARIE
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE
Last Name:MCCHESNEY
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 1:831 E HENRY RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-9100
Mailing Address - Country:US
Mailing Address - Phone:971-281-1816
Mailing Address - Fax:
Practice Address - Street 1:831 E HENRY RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-9100
Practice Address - Country:US
Practice Address - Phone:971-281-1816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR094000667RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse