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Individual

DR. ELIZABETH ANNE HESKETT BOURESSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
734 ELM ST SW, ALBANY, OR 97321-1934
(541) 812-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD203466
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
082623
OR
Enumeration date
02/13/2006
Last updated
06/20/2023
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