NPI 1083738595

Mary Kathleen Lane, PAC

Practitioner Medical Physician Assistant Lebanon, OR

Practice location

Address: 325 Park St, Lebanon, OR 97355-4229
Phone: (541) 451-7200
Fax: (541) 451-7207
Mailing address: PO Box 1193, Corvallis, OR 97339-1193

Registered specialties (2)

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA01341 (OR)

Other Physician Assistant providers in Oregon →

Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 085-000746 (IL)

Registry record

NPI: 1083738595
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Mar 2007
Record last updated: 5 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.