Individual
MS. SUSAN CAROL KEISTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
527 NW 27TH AVENUE, CORVALLIS, OR 97330
(541) 766-6835
(541) 847-5144
Mailing address
2305 NW 13TH ST, CORVALLIS, OR 97330-1431
(541) 740-0630
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229273
—
OR
Enumeration date
12/08/2005
Last updated
07/08/2007
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