Provider Demographics
NPI:1699668053
Name:LAFLEN, CONNOR ANTONY
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:ANTONY
Last Name:LAFLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 SW CHUNUT CT
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-6719
Mailing Address - Country:US
Mailing Address - Phone:503-490-4002
Mailing Address - Fax:
Practice Address - Street 1:1601 SW JEFFERSON AVE # 203
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331-8656
Practice Address - Country:US
Practice Address - Phone:541-974-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0014544390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program