Individual
DIANE HENNACY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
245 VALLEY VIEW DR, MEDFORD, OR 97504-6973
(541) 770-3171
Mailing address
245 VALLEY VIEW DR, MEDFORD, OR 97504-6973
(541) 770-3171
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD25438
OR
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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