Provider Demographics
NPI:1891377057
Name:C ALYSE LA MONTE PMHNP LLC
Entity Type:Organization
Organization Name:C ALYSE LA MONTE PMHNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:ALYSE
Authorized Official - Last Name:LAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:503-584-1941
Mailing Address - Street 1:528 COTTAGE ST NE STE 340
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3788
Mailing Address - Country:US
Mailing Address - Phone:503-584-1941
Mailing Address - Fax:503-689-1812
Practice Address - Street 1:528 COTTAGE ST NE STE 340
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3788
Practice Address - Country:US
Practice Address - Phone:503-584-1941
Practice Address - Fax:503-689-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty