Individual
DR. JONATHAN YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD15041
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050006883
RR MEDICARE
OR
05
—
1027432
—
WA
05
—
149401
—
OR
05
—
XPY200332
—
CA
Enumeration date
08/05/2006
Last updated
07/24/2023
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