Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 12884 | CA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 201050159NP | OR |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP30006316 | WA |
NPI | 1093836934 |
---|---|
Provider Name | Dawn Mary Allen |
First Address | Lake Oswego, OR 97034-5946 |
Second Address | Lake Oswego, OR 97034-5946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 27/03/2014 |