Individual
DR. DIANE M KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3509 NW SAMARITAN DR STE 201, CORVALLIS, OR 97330-3893
(541) 768-4260
Mailing address
PO BOX 84741, MS 316006, SEATTLE, WA 98124
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD21183
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050065206
RR MEDICARE
OR
05
—
130074
—
OR
05
—
805344700
—
ID
05
—
8231854
—
WA
05
—
XPY199011
—
CA
Enumeration date
07/22/2006
Last updated
01/28/2013
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