Provider Demographics
NPI:1316909187
Name:CRAFT, ALISSA PAULA (DO)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:PAULA
Last Name:CRAFT
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:136 SW WASHINGTON AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4877
Mailing Address - Country:US
Mailing Address - Phone:602-770-8967
Mailing Address - Fax:541-768-4907
Practice Address - Street 1:3600 NW SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3737
Practice Address - Country:US
Practice Address - Phone:541-768-4906
Practice Address - Fax:541-768-4907
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2009-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ28792080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine