Individual
ALYSSA CHARBONEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC, CLC
Contact information
Practice address
1361 MODOC ST, SPRINGFIELD, OR 97477-4124
(541) 206-7970
Mailing address
1361 MODOC ST, SPRINGFIELD, OR 97477-4124
(541) 206-7970
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
201800176RN
OR
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-315382
OR
Other
Enumeration date
07/23/2024
Last updated
02/11/2025
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