Individual
MIRANDA LEE MARKESTEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3640 NW SAMARITAN DR STE 120, CORVALLIS, OR 97330-3738
(541) 768-5223
(540) 536-0235
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60613313
WA
363AS0400X
Surgical Physician Assistant
0110006164
VA
363AS0400X
Surgical Physician Assistant
Primary
PA201988
OR
363AS0400X
Surgical Physician Assistant
PA9108211
FL
Other
Enumeration date
02/16/2015
Last updated
10/09/2025
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