Provider Demographics
NPI:1245416544
Name:DIXON, ALANNA R (PA-C)
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:R
Last Name:DIXON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:503-215-6644
Practice Address - Street 1:1698 E. MCANDREWS RD
Practice Address - Street 2:SUITE 400
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5590
Practice Address - Country:US
Practice Address - Phone:541-732-6000
Practice Address - Fax:541-732-6005
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
ORPA157157363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPA157157OtherOREGON LICENSE
FLPA 9104466OtherMEDICAL LICENSE
FLAJ404ZMedicare PIN
ORPA157157OtherOREGON LICENSE