Individual
MICAL THOMAS DUTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97470-6523
(541) 440-1000
Mailing address
PO BOX 716, WILBUR, OR 97494-0716
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
—
OR
282N00000X
General Acute Care Hospital
094006089N1 FNP-PP
OR
Other
Enumeration date
08/11/2006
Last updated
09/11/2025
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