Individual
SEAN JOSEPH PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 258-2101
(541) 451-7862
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD193346
OR
Other
Enumeration date
05/11/2016
Last updated
11/10/2020
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