Individual
EVITA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4000
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R2160
TX
207R00000X
Internal Medicine Physician
DO190984
OR
207R00000X
Internal Medicine Physician
O-1442
ID
207R00000X
Internal Medicine Physician
OP61183753
WA
207R00000X
Internal Medicine Physician
Primary
R2160
TX
208D00000X
General Practice Physician
R2160
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P02607793
RR MCR
TX
Enumeration date
09/02/2014
Last updated
02/11/2025
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