Individual
MRS. SHARI LAVIDA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
115 SW PINE STREET, CANYONVILLE, OR 97417-0198
(541) 839-4211
(541) 839-4858
Mailing address
PO BOX 198, PO BOX 748, CANYONVILLE, OR 97417-0198
(541) 839-4211
(541) 839-4858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200050018NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268782
—
OR
Enumeration date
01/05/2007
Last updated
01/23/2012
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