Individual
JANE CORBOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1620 E 12TH ST, THE DALLES, OR 97058-3213
(541) 296-9151
(541) 296-9156
Mailing address
1620 E 12TH ST, PO BOX 1520, THE DALLES, OR 97058-3213
(541) 296-9151
(541) 296-9156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G3248
TX
207Q00000X
Family Medicine Physician
Primary
MD150490
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137841605
—
TX
05
—
137841611
—
TX
05
—
218112
—
OR
Enumeration date
10/17/2006
Last updated
11/13/2014
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