Provider Demographics
NPI:1629638952
Name:VERNON, ALANA C (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:C
Last Name:VERNON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:
Other - Last Name:LEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 SW SCALEHOUSE LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1255
Mailing Address - Country:US
Mailing Address - Phone:541-316-0805
Mailing Address - Fax:541-241-7670
Practice Address - Street 1:392 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759-0439
Practice Address - Country:US
Practice Address - Phone:541-316-0805
Practice Address - Fax:541-241-7670
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR632912251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic