Individual
KEVIN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 NW 1ST ST, CORVALLIS, OR 97330-4836
(458) 217-3040
Mailing address
PO BOX 1414, CORVALLIS, OR 97339-1414
(458) 217-3040
(855) 962-2388
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000107998
OR
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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