Provider Demographics
NPI:1952083453
Name:CALANDE, ALEXANDRIA DANIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:DANIELLE
Last Name:CALANDE
Suffix:
Gender:F
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 1:2775 SW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1254
Mailing Address - Country:US
Mailing Address - Phone:541-504-6010
Mailing Address - Fax:541-615-9301
Practice Address - Street 1:2088 NE KIM LN
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6588
Practice Address - Country:US
Practice Address - Phone:458-666-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA214890363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant