Provider Demographics
NPI:1326394198
Name:ALVALE, EMILY ROSE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:ALVALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ROSE
Other - Last Name:WEIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:SUBLIMITY
Mailing Address - State:OR
Mailing Address - Zip Code:97385-0886
Mailing Address - Country:US
Mailing Address - Phone:503-769-2259
Mailing Address - Fax:503-769-8049
Practice Address - Street 1:114 SE CHURCH ST
Practice Address - Street 2:
Practice Address - City:SUBLIMITY
Practice Address - State:OR
Practice Address - Zip Code:97385-9424
Practice Address - Country:US
Practice Address - Phone:503-769-2259
Practice Address - Fax:503-769-8049
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60303568207Q00000X
CAA137392207Q00000X
OR191425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine