Individual
TRISTAN MCKIBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 SW JEFFERSON AVE, CORVALLIS, OR 97331-8656
(541) 737-3424
Mailing address
PO BOX 70723, SPRINGFIELD, OR 97475-0135
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0014268
OR
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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