Individual
KEVIN CHIAPPONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
990 NW CIRCLE BLVD STE 102, CORVALLIS, OR 97330-1967
(541) 768-5486
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA167457
OR
363AM0700X
Medical Physician Assistant
51461
CA
363AS0400X
Surgical Physician Assistant
PA167457
OR
Other
Enumeration date
02/24/2014
Last updated
11/06/2020
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