Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD23582 | OR |
N | 111NI0900X | Internist | MD23582 | OR |
Y | 207RX0202X | Medical Oncology | MD23582 | OR |
NPI | 1124034681 |
---|---|
Provider Name | Devon Jean Webster |
First Address | Corvallis, OR 97330-3757 |
Second Address | Corvallis, OR 97330-3757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 01/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1032645 | (05) | WA |
286495 | (05) | OR |
H61404 | (02) |