Provider Demographics
NPI:1134449580
Name:HALBERT, ALLISON M (LMT)
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:M
Last Name:HALBERT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8784 SW MARSEILLES DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9042
Mailing Address - Country:US
Mailing Address - Phone:503-913-2336
Mailing Address - Fax:
Practice Address - Street 1:1165 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3521
Practice Address - Country:US
Practice Address - Phone:541-343-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16763174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist