Individual
SEA-OH MCCONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3517 NW SAMARITAN DR STE 201, CORVALLIS, OR 97330-3769
(541) 768-5142
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO208156
OR
207Q00000X
Family Medicine Physician
OS020625
PA
Other
Enumeration date
12/15/2014
Last updated
10/13/2022
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