Individual
MICHAEL ANTHONY CARRASQUILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 NW ELKS DR, CORVALLIS, OR 97330-3757
(541) 768-5220
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.071902
IL
2085R0001X
Radiation Oncology Physician
MD210012205
DC
2085R0001X
Radiation Oncology Physician
Primary
MD223368
OR
Other
Enumeration date
06/18/2018
Last updated
06/27/2025
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