Allen, Mitzie Althea

Allen, Mitzie Althea is an individual health care provider with primary practice located at 1270 Kotnum Road , Warm Springs OR 97761. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Allen, Mitzie Althea can be contacted via phone (541) 553-2134.

Contact Information

Primary practice address
1270 Kotnum Road Warm Springs OR 97761
Phone: (541) 553-2134
Fax: (541) 553-2481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X 22933 Massachusetts

Profile Details

NPI number 1508863317
LBN Legal business name Allen, Mitzie Althea
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508863317 NPPES
Oregon MEDICAID 139290

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