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Individual

MS. KATHRYN I MCQUILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD29262
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500607933
OR
Enumeration date
04/17/2007
Last updated
07/30/2014
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