Provider Demographics
NPI:1477655264
Name:ALL WOMENS CARE P C
Entity Type:Organization
Organization Name:ALL WOMENS CARE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTPHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LYNCH MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-388-8253
Mailing Address - Street 1:25 NW LOUISIANA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3203
Mailing Address - Country:US
Mailing Address - Phone:541-388-8253
Mailing Address - Fax:541-617-0894
Practice Address - Street 1:25 NW LOUISIANA AVE
Practice Address - Street 2:STE 100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3203
Practice Address - Country:US
Practice Address - Phone:541-388-8253
Practice Address - Fax:541-617-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17286/20470174400000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150265/066659Medicaid
G50086/F92975Medicare UPIN
OR114350Medicare ID - Type Unspecified