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NPI Code Detail

MEDICARE: CALLA MICHALAK

MEDICARE: CALLA MICHALAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024181097VA
2363LF0000XFamily Nurse Practitioner10006558OR

General Provider Information

NPI Number : 1902484751
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLA MICHALAK
Provider Business Mailing Address
First Line : 1001 MOLALLA AVE STE 202
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-3768
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : CLAIRMONT HALL
Second Line : 19600 MOLALLA AVE
City : OREGON CITY
State : OR
Zip : 97045-3768
Country : US
Telephone Number : 503-722-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2021
Last Update Date : 07/19/2023

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Directions to “ CALLA MICHALAK ” Practice Location

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