Provider Demographics
NPI:1730295791
Name:O'CONNOR, DAWN ALISON (FNP)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ALISON
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:ALISON
Other - Last Name:LIDDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:981 NW SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2111
Mailing Address - Country:US
Mailing Address - Phone:541-758-0766
Mailing Address - Fax:541-753-2737
Practice Address - Street 1:925 COMMERCIAL ST SE STE 102
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4173
Practice Address - Country:US
Practice Address - Phone:541-758-0766
Practice Address - Fax:541-753-2737
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA514577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily