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Individual

DR. ALFONSO OLIVA TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
305 THORA CIRCLE DR., WINCHESTER, OR 97495
(541) 673-4516
Mailing address
PO BOX 534, WINCHESTER, OR 97495-0534
(541) 673-4516

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD13317
OR

Other

Enumeration date
07/14/2009
Last updated
07/14/2009
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