Individual
DR. MARY A LOEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD165012
OR
207QA0401X
Addiction Medicine (Family Medicine) Physician
MD165012
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500666605
—
OR
Enumeration date
03/18/2006
Last updated
04/21/2015
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