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Individual

DR. REJEESH MENON MANCHEZHATHU RAJAGOPALAMENON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3043 NE 28TH ST, LINCOLN CITY, OR 97367-4518
(541) 994-3661
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD214390
OR
207R00000X
Internal Medicine Physician
MD60611570
WA
208M00000X
Hospitalist Physician
MD60611570
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720424476
WA
05
2063862
WA
01
P01713934
RR PTAN WVH
WA
Enumeration date
05/21/2013
Last updated
07/14/2025
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