Individual
LANCE MCQUILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3517 NW SAMARITAN DR STE 201, CORVALLIS, OR 97330-3769
(541) 768-5142
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
50437
WI
207Q00000X
Family Medicine Physician
Primary
MD26238
OR
Other
Enumeration date
07/13/2006
Last updated
03/15/2021
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