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NPI Code Detail

MEDICARE: ALLISON P ORTEGA M.S.

MEDICARE: ALLISON P ORTEGA M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1170300000XGenetic Counselor (M.S.)9093467-3601UT

General Provider Information

NPI Number : 1366881989
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON P ORTEGA M.S.
Provider Business Mailing Address
First Line : 2677 E PARLEYS WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1617
Country : US
Telephone Number : 801-931-6230
Fax Number :
Provider Business Practice Location Address
First Line : 2677 E PARLEYS WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1617
Country : US
Telephone Number : 801-931-6230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2013
Last Update Date : 12/12/2024

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Directions to “ ALLISON P ORTEGA M.S.” Practice Location

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