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Individual

DR. MARISA STOLLER BRANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A101202
CA
207L00000X
Anesthesiology Physician
Primary
MD152658
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500627460
OR
Enumeration date
09/22/2007
Last updated
07/21/2023
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