Provider Demographics
NPI:1083886170
Name:DURAND, ALEXIS ROANE (STATE OF OREGON LMT)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:ROANE
Last Name:DURAND
Suffix:
Gender:F
Credentials:STATE OF OREGON LMT
Other - Prefix:MS
Other - First Name:ALI
Other - Middle Name:ROANE
Other - Last Name:DURAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:STATE OF OREGON LMT
Mailing Address - Street 1:243 LORETTA WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3265
Mailing Address - Country:US
Mailing Address - Phone:541-688-3570
Mailing Address - Fax:
Practice Address - Street 1:243 LORETTA WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3265
Practice Address - Country:US
Practice Address - Phone:541-688-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6853225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist