Most Relevant Information
Provider Data
| NPI Number: | 1003393976 |
| Provider Name: | BLUE ELIZABETH VALENTINE |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/24/2018 |
| Last Updated: | 07/24/2018 |
Provider Practice Location
4077 SW RESEARCH WAY
CORVALLIS
OR
973331065
Practice Location Phone/Fax
| Phone: | 5417666835 |
| Fax: | 5417666186 |
Provider Mailing Location
4077 SW RESEARCH WAY
CORVALLIS
OR
973331065
Provider Mailing Phone/Fax
| Phone: | 5417666835 |
| Fax: | 5417666186 |