Individual
MR. TERRY WAYNE SHORTRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 N 5TH ST, LEBANON, OR 97355-2875
(541) 451-6282
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD16008
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094276
—
OR
Enumeration date
07/21/2006
Last updated
03/11/2026
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