Healthcare Provider Details

I. General information

NPI: 1700806445
Provider Name (Legal Business Name): ALLAN STEVEN MEHR D.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/09/2007
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:
Title or Position:
Credential:
Phone: