Healthcare Provider Details

I. General information

NPI: 1770007015
Provider Name (Legal Business Name): ALLISON RENE FRANK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/21/2022
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3099 RIVER RD S STE 120
SALEM OR
97302-9754
US

IV. Provider business mailing address

3099 RIVER RD S STE 120
SALEM OR
97302-9754
US

V. Phone/Fax

Practice location:
  • Phone: 503-485-2581
  • Fax: 503-485-2564
Mailing address:
  • Phone: 503-485-2581
  • Fax: 503-485-2564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number030891
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: