Individual
THEORAM MICHAEL BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3680 NW SAMARITAN DR STE 100, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10005506
OR
Other
Enumeration date
09/14/2023
Last updated
01/21/2026
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