Individual
ANNA U SEVERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1000 SE UGLOW AVE, DALLAS, OR 97338-2645
(503) 623-8376
(503) 623-5293
Mailing address
1356 S WATER ST, SILVERTON, OR 97381-2427
(503) 873-6985
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00266
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231084
—
OR
Enumeration date
04/10/2006
Last updated
02/16/2010
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