| |
990 Nw Circle Blvd, Suite 201, Corvallis, OR 97330-1967 | |
(541) 768-6412 | |
(541) 768-6643 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 990 Nw Circle Blvd, Corvallis, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154697001 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
171100000X | Acupuncturist | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
990 Nw Circle Blvd, Suite 201, Corvallis, OR 97330-1967 Ph: (541) 768-6412 | 990 Nw Circle Blvd, Suite 201, Corvallis, OR 97330-1967 Ph: (541) 768-6412 |