Provider Demographics
NPI:1306961297
Name:ALLAN STEVEN MEHR
Entity type:Organization
Organization Name:ALLAN STEVEN MEHR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:DA
Authorized Official - Phone:503-364-2828
Mailing Address - Street 1:120 RAMSGATE SQ S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5868
Mailing Address - Country:US
Mailing Address - Phone:503-364-2828
Mailing Address - Fax:503-364-4327
Practice Address - Street 1:120 RAMSGATE SQ S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5868
Practice Address - Country:US
Practice Address - Phone:503-364-2828
Practice Address - Fax:503-364-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20459237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227819Medicaid
OR227819Medicaid