Individual
ALLISON KAYE SURAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
404 NE PENN AVE, BEND, OR 97701-4264
(541) 318-7041
(541) 388-3711
Mailing address
20813 PENNY LN, BEND, OR 97703-8750
(541) 390-6723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1713
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201046
—
OR
01
—
570944
PROVIDENCE
OR
01
—
H254801
PACIFIC SOURCE
OR
Enumeration date
12/06/2005
Last updated
12/29/2016
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