Organization
THE CORVALLIS CLINIC P C
Active
Parent organization
THE CORVALLIS CLINIC P C
Other names
Corvallis Clinic Waverly Drive
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CORVALLIS CLINIC P C
Authorized official
MR. THOMAS GRAGNOLA M.D. (PRESIDENT)
(541) 754-1374
Entity
Organization
Contact information
Practice address
1705 WAVERLY DR SE, ALBANY, OR 97322-6952
(541) 967-8221
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1374
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
01/24/2025
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