Kelley, Mary Allegra
Kelley, Mary Allegra is an individual health care provider with primary practice located at 1501 Ne Medical Center Dr , Bend OR 97701-6099. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Kelley, Mary Allegra can be contacted via phone (541) 382-4900.Contact Information
Primary practice address
1501 Ne Medical Center Dr
Bend OR 97701-6099
Phone: (541) 382-4900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | BP10067289 | Texas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | DO212875 | Oregon |
Profile Details
| NPI number | 1720646862 |
|---|---|
| LBN Legal business name | Kelley, Mary Allegra |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2019 |
| Last updated | Sep 15th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720646862 | NPPES |
| Oregon | MEDICAID | 500820545 |
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