Individual
MRS. AMANDA MCALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130586LPN
OR
Other
Enumeration date
07/08/2013
Last updated
08/05/2013
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