Individual
MR. JAMES EDWARD DOMST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
690 N MAIN ST, MOUNT ANGEL, OR 97362-9518
(503) 845-2000
(503) 845-2384
Mailing address
PO BOX 278, WOODBURN, OR 97071-0278
(971) 983-5260
(971) 983-5326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25856
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027908
—
OR
Enumeration date
05/05/2006
Last updated
12/02/2017
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