Latta, Priscilla W

Latta, Priscilla W is an individual health care provider with primary practice located at 400 Hickory St Nw Ste 101 , Albany OR 97321-1700. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is her primary health care specialty. Latta, Priscilla W can be contacted via phone (541) 812-3360.

Contact Information

Primary practice address
400 Hickory St Nw Ste 101 Albany OR 97321-1700
Phone: (541) 812-3360
Fax: (541) 812-4499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD151051 Oregon
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X MD151051 Oregon

Profile Details

NPI number 1639154974
LBN Legal business name Latta, Priscilla W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Oct 29th, 2020 - about 4 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 1639154974 NPPES
Oregon MEDICAID 500623286

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