Provider Demographics
NPI:1134183999
Name:ALLEN, LYNNE M (MN, ARNP)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:M
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MN, ARNP
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:M
Other - Last Name:STEIGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MN, ARNP
Mailing Address - Street 1:1700 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3317
Mailing Address - Country:US
Mailing Address - Phone:541-296-7760
Mailing Address - Fax:541-296-7619
Practice Address - Street 1:1800 E 19TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3389
Practice Address - Country:US
Practice Address - Phone:541-296-7585
Practice Address - Fax:541-296-7610
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006081363L00000X
OR201406805NP-PP363L00000X
WARN00114242363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9633975Medicaid
OR5006433999Medicaid
WAG8878347Medicare PIN
WA9633975Medicaid