Individual
DR. KRISTA J HENDRICKS
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) 757-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD29283
OR
390200000X
Student in an Organized Health Care Education/Training Program
0116017465
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500612460
—
OR
05
—
8557464
—
WA
01
—
P00830754
RAILROAD MEDICARE
OR
Enumeration date
05/03/2007
Last updated
07/24/2023
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