Dr. KITIMA BOONVISUDHI
Individual Provider (NPI-1)
Active
Surgery
Provider Information
- NPI Number
1134198005- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 400 HICKORY ST NW STE 101, ALBANY, OR, 973211700
- Phone
- (541) 812-3360
Specialties & Taxonomies
Surgery
License: NY #204411
Surgery
License: WI #59966
Surgery
Primary License: OR #MD167013
All Addresses
MAILING
PO BOX 1189
CORVALLIS, OR, 973391189