MRS. MARY KATHLEEN LANE (NPI# 1083738595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083738595 |
| Entity Type | Individual |
| Full Name | MRS. MARY KATHLEEN LANE |
| Credential | PA-C |
| Practice Address |
325 Park St Lebanon OR 97355-4229 |
| Mailing Address |
Po Box 1193 Corvallis OR 97339-1193 |
| Practice Telephone | 5414517200 |
| Practice Fax Number | 5414517207 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA01341 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085-000746 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295130839 | Mary Elizabeth Lane | Nurse Practitioner | 1350a Cleveland St, Greenville, SC 29607-2408 | 2014-10-24 |
| 1629237284 | Mary P Lane | Nurse Practitioner | Stony Brook Univ Med Ical Ctr, T12, 080 Health Science Center, Stony Brook, NY 11794-0001 | 2008-06-08 |
| 1871634683 | Mary Penfield Lane | Nurse Practitioner | 5369 Pineywood Rd, Birmingham, AL 35242-3424 | 2007-02-12 |
| 1487767091 | Mary Anne Lane | Registered Nurse | 340 Seminary St., Kenansville, NC 28349 | 2006-08-16 |
| 1033105291 | Mary Boggs Lane | Family Medicine | Cherokee County Health Department, 228 Hilton Street, Murphy, NC 28906-2814 | 2005-09-23 |
| 1649801614 | Mary Lane | Physical Therapist | 1854 W Auburn Rd Ste 200, Rochester Hills, MI 48309-3868 | 2020-01-29 |
| 1144871914 | Mary Margaret Lane | Social Worker | 500 Victory Rd, Quincy, MA 02171-3139 | 2019-09-24 |
| 1134778715 | Mary Patricia Lane | Behavior Technician | 925 Conference Dr, Greenville, NC 27858-5971 | 2019-09-06 |
| 1508366238 | Mary C Lane | Licensed Vocational Nurse | 11049 W Hoffman Dr, Odessa, TX 79764-9043 | 2018-02-19 |
| 1518470327 | Mary Alice Lane | Registered Nurse | 5231 Penn Ave, Pittsburgh, PA 15224-1768 | 2017-11-15 |
| Street Address |
325 PARK ST |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962476580 | Mary E Wunderle-mcintosh | Family Medicine | 325 Park St, Lebanon, OR 97355-4229 | 2006-02-13 |
| 1942778410 | Anna Louise Jacobi | Nurse Practitioner | 325 Park St, Lebanon, OR 97355-4229 | 2018-11-02 |
| 1427315662 | Mid-valley Healthcare, Inc. | Clinic/Center | 325 Park St, Lebanon, OR 97355-4229 | 2012-04-12 |
| 1003068933 | Jinny A Farrar | Physician Assistant | 325 Park St, Lebanon, OR 97355-4229 | 2008-10-22 |
| 1134156003 | Thad L. Nelson | Family Medicine | 325 Park St, Lebanon, OR 97355-4229 | 2006-06-27 |
| 1770529919 | C Ben Johnson | Physician Assistant | 325 Park St, Lebanon, OR 97355-4229 | 2006-06-22 |
| 1336181106 | Kenneth L. Orwick | Family Medicine | 325 Park St, Lebanon, OR 97355-4229 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
| Find all providers in zip 97355 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
| 1841843174 | Jesse Paul Laughner | Physician Assistant | 735 Norman Dr Ste 8, Lebanon, PA 17042-7559 | 2019-07-16 |
| 1881868750 | Oronzo Ronald Schiraldi | Physician Assistant | 7 Deer Run, Lebanon, NJ 08833-3004 | 2008-04-22 |
| 1740211788 | Tammie Wampler | Physician Assistant | 107 Glidepath Way, Lebanon, TN 37090-4133 | 2006-07-06 |
| 1487610069 | Erin Mcculloch Crisp | Physician Assistant | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-04-24 |
| 1023013620 | Richard B Halbur | Physician Assistant | 191 N Main St, Lebanon, OR 97355-2870 | 2005-06-20 |
| 1326679366 | Joshua Christopher Schirripa | Physician Assistant | 675 N 5th St Ste 200, Lebanon, OR 97355-2875 | 2020-01-29 |
| 1245878420 | Lauren Michelle Eastman | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2019-12-18 |
| 1164079091 | Sarah A Muse | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2019-08-26 |
| 1356812291 | David Lawrence Federoff | Physician Assistant | 35 Mullins Dr Ste 2, Lebanon, OR 97355-3985 | 2018-12-17 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.