Individual
DR. CHARLA VANKOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 SW 8TH ST, CORVALLIS, OR 97333-4544
(541) 753-8343
Mailing address
223 SW 8TH ST, CORVALLIS, OR 97333-4544
(541) 753-8343
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1220
OR
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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