| Doctor Name: | ALLEN DEAN BOTTORFF |
| NPI Number: | 1932419546 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 201041846RN |
| Business Practice Address: | 83010 Hungry Hill Creswell, OR - 97426 |
| Business Phone Number: | 5419155819 |
| Business Fax Number: | 5418952636 |
| Mailing Address: | P.o. Box 36, 83010 Hungry Hill CRESWELL |
| State: | OR |
| Postal Code: | 97426 |
| Phone Number: | 5419155819 |
| Fax Number: | |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 10/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 201041846RN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |