Individual
KRYSTAL THOMAS SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2700 SE STRATUS AVE, SUITE 406, MCMINNVILLE, OR 97128-6255
(503) 435-1200
(503) 274-5400
Mailing address
2700 SE STRATUS AVE, SUITE 406, MCMINNVILLE, OR 97128
(503) 435-1200
(503) 434-9572
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO172095
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500690584
—
OR
Enumeration date
04/08/2009
Last updated
08/02/2017
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