Provider Demographics
NPI:1902528789
Name:DARLING, ANNALISE H (PA-C)
Entity type:Individual
Prefix:
First Name:ANNALISE
Middle Name:H
Last Name:DARLING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNALISE
Other - Middle Name:H
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 14001
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-5014
Mailing Address - Country:US
Mailing Address - Phone:503-814-3343
Mailing Address - Fax:
Practice Address - Street 1:1475 MOUNT HOOD AVE STE 110
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9196
Practice Address - Country:US
Practice Address - Phone:971-983-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA213375363AM0700X
OR363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical