Mallory, Loren E
Mallory, Loren E is an individual health care provider with primary practice located at 619 Madison St Ste 108 , Oregon City OR 97045-2354. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Mallory, Loren E can be contacted via phone (503) 303-4257.Contact Information
Primary practice address
619 Madison St Ste 108
Oregon City OR 97045-2354
Phone: (503) 303-4257
Fax: (503) 387-3957
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0978 | Oregon |
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 978 | Oregon |
Profile Details
| NPI number | 1992853402 |
|---|---|
| LBN Legal business name | Mallory, Loren E |
| Credentials | PHD, ABPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Apr 9th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992853402 | NPPES |
| Other | 117227 | MHN HMC | |
| MEDICAID | 042544 | MHN HMC |
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