Individual
LUIS RUSSELL VELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3620 NW SAMARITAN DR STE 201, CORVALLIS, OR 97330-3785
(541) 768-6300
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D020838
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150331
—
OR
Enumeration date
01/03/2006
Last updated
11/06/2020
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