SearchOregon207RI0200X

Jill Provaznik, MD

NPI 1992185995 · on the registry since 2015

Practice

Address
3640 Nw Samaritan Dr Ste 210
Corvallis, OR 97330
Phone
(541) 768-5810
Organisation at this address
Jaffer H Bashey Md Pc
Lisa A. Cornelius Dpm Pc
Oral Surgery Associates, Pc
Good Samaritan Hospital Corvallis
Good Samaritan Hospital Corvallis
Inferred from a shared address, not stated in the registry.
Clinicians at this address
70

Additional practice sites

  • 30 N 1900 E Rm 4b319, Salt Lake City, UT
  • 9205 Sw Barnes Rd, Portland, OR

Registry record

Primary taxonomy
207RI0200X
207RI0200X
Also registered as
207R00000X
207RI0200X
Licence states on file
OR, UT
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-05-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon