Individual
ALLEGRA DANIELLE ANDERSON LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LDM
Contact information
Practice address
19800 VILLAGE OFFICE CT STE 105, BEND, OR 97702-1813
(541) 647-1788
Mailing address
9156 SW SUNDOWN CANYON RD, TERREBONNE, OR 97760-9377
(503) 860-6361
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
17100004
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17100004
NARM
TN
Enumeration date
10/11/2017
Last updated
10/11/2017
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