=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477655264
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL WOMENS CARE P C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2006
-----------------------------------------------------
Last Update Date | 11/21/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 NW LOUISIANA AVE STE 100
-----------------------------------------------------
City | BEND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97701-3203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-388-8253
-----------------------------------------------------
Fax | 541-617-0894
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 NW LOUISIANA AVE STE 100
-----------------------------------------------------
City | BEND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97701-3203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-388-8253
-----------------------------------------------------
Fax | 541-617-0894
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENTPHYSICIAN
-----------------------------------------------------
Name | MS. ALISON KAY LYNCH MILLER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 541-388-8253
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number | 17286/20470
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 17286/20470
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------