Waller, Laura

Waller, Laura is an individual health care provider with primary practice located at 615 Ne 15Th St , Mcminnville OR 97128-3399. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Waller, Laura can be contacted via phone (503) 565-4200.

Contact Information

Primary practice address
615 Ne 15Th St Mcminnville OR 97128-3399
Phone: (503) 565-4200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X ATAT10185313 Oregon

Profile Details

NPI number 1386102432
LBN Legal business name Waller, Laura
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2019
Last updated Mar 7th, 2019 - about 6 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 1386102432 NPPES
Oregon Other ATAT10185313 OREGON HEALTH LICENCING BOARD

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