Provider Demographics
NPI:1649325903
Name:ALLEN, LOUISE (RN)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 NW KAISER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-1541
Mailing Address - Country:US
Mailing Address - Phone:503-645-5842
Mailing Address - Fax:
Practice Address - Street 1:707 NW EVERETT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3517
Practice Address - Country:US
Practice Address - Phone:503-222-4906
Practice Address - Fax:503-222-3215
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR079022045N3163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health