Ian Alley, PA-C
Physician Assistant in Portland, ME. Individual provider (NPI-1).
NPI number1487377842
StatusActive
Last updated in NPPESJan 18, 2023
Details
- NPI
- 1487377842
- Entity type
- Individual (NPI-1)
- Name
- Ian Alley
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 21, 2022
- Certification date
- Jan 18, 2023
- Last updated
- Jan 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA2457 | ME | Yes |
Practice location
22 Bramhall StPortland, ME 04102-3134
Phone 207-662-4618
Mailing address
1 Boston Way Unit 107Newburyport, MA 01950-4181
Phone 617-304-5894
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