Healthcare Provider Details

I. General information

NPI: 1609710474
Provider Name (Legal Business Name): ALLISON MARIE PURVINE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 BELLEVUE ST SE
SALEM OR
97301-4006
US

IV. Provider business mailing address

1002 BELLEVUE ST SE
SALEM OR
97301-4006
US

V. Phone/Fax

Practice location:
  • Phone: 503-814-5554
  • Fax:
Mailing address:
  • Phone: 503-814-5554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10059455
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number10059455
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: