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Individual

DR. ETHAN W. GAUMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD25160
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
275295
OR
05
8034217
WA
05
807297900
ID
01
P00203043
RR MEDICARE
OR
Enumeration date
02/17/2006
Last updated
12/08/2025
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