Healthcare Provider Details

I. General information

NPI: 1801317078
Provider Name (Legal Business Name): DANA MCGLOHN RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 3RD AVE SW
ALBANY OR
97321-2272
US

IV. Provider business mailing address

1204 NW 10TH ST
CORVALLIS OR
97330-4521
US

V. Phone/Fax

Practice location:
  • Phone: 541-967-3866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number092006926RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: