Individual
LYDIA ANN FUSETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1835 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 753-3542
(541) 752-0952
Mailing address
1835 NW KINGS BLVD, CORVALLIS, OR 97330
(541) 753-3542
(541) 752-0952
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD12443
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268359
—
OR
Enumeration date
07/31/2006
Last updated
04/25/2025
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