Provider Demographics
NPI:1669578845
Name:ALBRIGHT, ALAN DEVAL (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:DEVAL
Last Name:ALBRIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 S.W. US VETERANS HOSPITAL ROAD
Mailing Address - Street 2:BOX 1034
Mailing Address - City:PORTLAND OREGON
Mailing Address - State:ID
Mailing Address - Zip Code:97239-2964
Mailing Address - Country:US
Mailing Address - Phone:503-220-9262
Mailing Address - Fax:503-273-5243
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:BOX 1034
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-9262
Practice Address - Fax:503-273-5243
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant