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Organization
MAE MEDICAL
Active
Organization
MAE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA JOHNSON FNP (OWNER/MANAGER)
(541) 600-2535
Entity
Organization
Contact information
Practice address
733 N 1ST ST, LAKEVIEW, OR 97630-1507
(541) 600-2535
Mailing address
93397 DAIRY CREEK LN, LAKEVIEW, OR 97630-9165
(541) 600-2535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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