Provider Demographics
NPI:1548613649
Name:HOWARTH, ALLYSON (MSN, WHNP, MA, IBCLC)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:HOWARTH
Suffix:
Gender:F
Credentials:MSN, WHNP, MA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1456
Mailing Address - Country:US
Mailing Address - Phone:541-523-4497
Mailing Address - Fax:541-523-5471
Practice Address - Street 1:182 SW ACADEMY ST STE 333
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1996
Practice Address - Country:US
Practice Address - Phone:503-623-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201604026NP-PP363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology