Individual provider · Type 1 NPI

Mary Kathleen Lane, PA-C

Medical Physician Assistant · Lebanon, OR

NPI number 1083738595 Active

Practice location

325 Park St
Lebanon, OR 97355-4229

Call (541) 451-7200 Map

Fax (541) 451-7207

Mailing address

PO Box 1193
Corvallis, OR 97339-1193

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA01341 (OR)
Medical Physician Assistant 363AM0700X085-000746 (IL)

Medical Physician Assistant: Definition to come...

10 other providers at this address

Other medical physician assistant providers in Lebanon

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About NPI 1083738595

Mary Kathleen Lane, PA-C's National Provider Identifier is 1083738595, issued on Mar 19, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lebanon, OR. The record was last updated on Nov 5, 2020.