Individual
LACEY ROYBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1793 13TH ST SE, SALEM, OR 97302-2541
(866) 599-3376
Mailing address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 768-4906
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DO188595
OR
Other
Enumeration date
05/01/2017
Last updated
11/10/2021
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