Individual
SVETLANA FEYTSER TISHCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 MULLINS DR, LEBANON, OR 97355-3983
(360) 910-2384
Mailing address
200 MULLINS DR, LEBANON, OR 97355-3983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS021289
PA
Other
Enumeration date
10/25/2014
Last updated
10/14/2021
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