Individual
THOMAS VANASCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 GEARY ST SE, ALBANY, OR 97322-6842
(541) 812-5500
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD11686
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010051720
RAILROAD MEDICARE
—
01
—
059297000
BC/BS OF OREGON
—
05
—
62315
—
OR
01
—
79196
WASHINGTON L&I
—
01
—
C94546
PROVIDENCE HEALTH PLAN
—
01
—
JT3251
PACC
—
05
—
XPY185193
—
CA
Enumeration date
04/04/2006
Last updated
11/03/2020
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