JILL M PROVAZNIK

CORVALLIS, OR
NPI1992185995
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207RI0200X Internal Medicine, Infectious Disease
(Licence: OR  MD189615)
Additional Taxonomies207R00000X Internal Medicine
(Licence: OR  MD189615)
207RI0200X Internal Medicine, Infectious Disease
(Licence: UT  11262304-1205)
Enumeration Date2015-06-04
Last Update Date2023-05-12
Business Address
JILL M PROVAZNIK MD
3640 NW SAMARITAN DR STE 210
CORVALLIS, OR 97330-3787
Phone number: 541-768-5810
Mailing Address
JILL M PROVAZNIK MD
PO BOX 1189
CORVALLIS, OR 97339-1189
Phone number: