Individual
TERESA ROLEEN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 PINE ST, KLAMATH FALLS, OR 97601
(541) 883-1998
(541) 850-5226
Mailing address
1000 PINE ST, KLAMATH FALLS, OR 97601
(541) 883-1998
(541) 850-5226
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD19413
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075085
—
OR
01
—
XPY185190
MEDICAL
CA
Enumeration date
12/20/2006
Last updated
07/16/2007
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