Individual
MISS ALICIA MARIE MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
995 WILLAGILLESPIE RD # 100, EUGENE, OR 97401-2186
(541) 484-5443
(541) 687-5621
Mailing address
501 N GRAHAM ST STE 300, PORTLAND, OR 97227-2008
(503) 413-4300
(503) 413-5301
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201050068NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201050068NP
STATE OF OREGON
OR
Enumeration date
06/29/2010
Last updated
10/27/2017
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