Individual
ALEXANDER MICHAEL GOLDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
850 SW 26TH ST, CORVALLIS, OR 97331-8624
(541) 737-9355
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA191536
OR
363AM0700X
Medical Physician Assistant
PA2013-0058
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326185YKWY
MEDICARE PTAN
NM
05
—
72728825
—
NM
Enumeration date
09/04/2013
Last updated
01/18/2024
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