Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | MD23725 | OR |
NPI | 1033169271 |
---|---|
Provider Name | Roland Solensky |
First Address | Corvallis, OR 97330-3745 |
Second Address | Corvallis, OR 97330-3737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 05/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287043 | (05) | OR |
H16873 | (02) |