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:
Health care specialties
Specialty | Code | License # | 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 5 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 | 1639154974 | NPPES |
Oregon | MEDICAID | 500623286 |
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