Healthcare Provider Details

I. General information

NPI: 1194774208
Provider Name (Legal Business Name): MAILE ANSLINGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 GEORGE JACKSON RD
MAUPIN OR
97037-9208
US

IV. Provider business mailing address

PO BOX 219
MAUPIN OR
97037-0219
US

V. Phone/Fax

Practice location:
  • Phone: 541-395-2911
  • Fax: 541-395-2912
Mailing address:
  • Phone: 541-395-2911
  • Fax: 541-395-2912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM8357
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD27642
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: