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General NPI Number Information
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NPI Number | 1073963013
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Entity Type | Individual
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Provider Name | HANNA LOU ALLWEIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 11958 SW GARDEN PLACE
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City | TIGARD
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State | OR
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Zip | 97223
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Country | US
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Telephone | 503-684-8252
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Fax | 866-859-8195
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Provider Business Mailing Address
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Address Line | 11958 SW GARDEN PLACE
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City | TIGARD
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State | OR
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Zip | 97223
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Country | US
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Telephone | 503-684-8252
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Fax | 866-859-8195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA61034282
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA192999
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License Number State | OR
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