Individual
CRISTINA CAPANNOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3031 NE STEPHENS ST, ROSEBURG, OR 97470-6237
(541) 229-7038
Mailing address
3600 NW SAMARITAN DR, GRADUATE MEDICAL EDUCATION ATTN: CHRISSY ANDERSON, CORVALLIS, OR 97330-3737
(541) 768-4906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
177234
OR
207Q00000X
Family Medicine Physician
Primary
DO194623
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2015
Last updated
07/12/2019
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