Healthcare Provider Details

I. General information

NPI: 1306961297
Provider Name (Legal Business Name): ALLAN STEVEN MEHR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 RAMSGATE SQ S
SALEM OR
97302-5868
US

IV. Provider business mailing address

120 RAMSGATE SQ S
SALEM OR
97302-5868
US

V. Phone/Fax

Practice location:
  • Phone: 503-364-2828
  • Fax: 503-364-4327
Mailing address:
  • Phone: 503-364-2828
  • Fax: 503-364-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number20459
License Number StateOR

VIII. Authorized Official

Name: DR. ALLAN STEVEN MEHR
Title or Position: AUDIOLOGIST
Credential: D.A.
Phone: 503-364-2828