Individual
COLTON LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-4906
Mailing address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-4906
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
PG230692
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2025
Last updated
05/04/2026
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