Provider Demographics
NPI:1487028361
Name:LAMOREAUX, TALLON (NP, PMHNP)
Entity type:Individual
Prefix:
First Name:TALLON
Middle Name:
Last Name:LAMOREAUX
Suffix:
Gender:M
Credentials:NP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61822 TEN BARR RANCH RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9314
Mailing Address - Country:US
Mailing Address - Phone:541-241-3500
Mailing Address - Fax:541-241-3600
Practice Address - Street 1:61822 TEN BARR RANCH RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9314
Practice Address - Country:US
Practice Address - Phone:541-241-3500
Practice Address - Fax:541-241-3600
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OR202009010NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor