Individual
MARK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 STEVENS ST, MEDFORD, OR 97504-6719
(541) 779-3551
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(971) 364-0611
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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