Provider Demographics
NPI:1174571244
Name:WESTFALL, LINDA LOU (WHCNP, NMNP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOU
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:WHCNP, NMNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1274
Mailing Address - Street 2:
Mailing Address - City:CANYONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97417-1274
Mailing Address - Country:US
Mailing Address - Phone:541-430-7305
Mailing Address - Fax:541-440-3505
Practice Address - Street 1:621 W MADRONE ST
Practice Address - Street 2:SUITE 223
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3090
Practice Address - Country:US
Practice Address - Phone:541-440-3521
Practice Address - Fax:541-440-3505
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000038040N7363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health