Michelle Dichoso Ballesteros, FOSTER CARE PROVIDER
Individual provider Active NPI Nursing Home Administrator · McMinnville, OR
NPI 1295573723 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1295573723
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nursing Home Administrator 376G00000X
- License
- 623110 (OR)
- Practice address
- 631 SW Taft St
McMinnville, OR 97128-6627 - Phone
- (971) 330-5503
- NPI assigned
- Jul 18, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 623110 | OR | MD | Nursing Home Administrator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 623110 | OR | Yes |
Addresses
Primary practice location
631 SW Taft St
McMinnville, OR 97128-6627
Mailing address
631 SW Taft St
McMinnville, OR 97128-6627
Phone (971) 330-5503
Other providers in McMinnville, OR
- Elizabeth Carol Bair
- Kenneth Earl Baker
- Amanda Baldoni
- Lisa Ann Balint
- Bethany Ball
- Gordon Earl Banks
- George T Barker
- Alicia Marie Barmettler
- Angela M Barnes
- Chad Barnett
All providers in McMinnville, OR · Nursing Home Administrator in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.