| Dallas Renae Holladay, | |
|
1046 6th Ave Sw, Albany, OR 97321-1916 | |
| (541) 812-4000 | |
| Not Available |
| Full Name | Dallas Renae Holladay |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Location | 1046 6th Ave Sw, Albany, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871834382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | DO195999 (Oregon) | Primary |
| 207P00000X | Emergency Medicine | 036139497 (Illinois) | Secondary |
| Entity Name | Foundation for Emergency Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467468280 PECOS PAC ID: 4981504198 Enrollment ID: O20040113000338 |
| Entity Name | Carle West Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Renae Holladay, Po Box 1189, Corvallis, OR 97339-1189 Ph: Not Available | Dallas Renae Holladay, 1046 6th Ave Sw, Albany, OR 97321-1916 Ph: (541) 812-4000 |
Alexander Ells, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |
Thomas Vanasche, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1700 Geary St Se, Albany, OR 97322 Phone: 541-812-5500 |
Nathan Alan Garton, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |
Mr. Blaine B. Rourke, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |
Evita Lopez, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |
Dr. Alex Jordan Pittman, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |
Megan Dell, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1046 6th Ave Sw, Albany, OR 97321 Phone: 541-812-4000 |