Healthcare Provider Details

I. General information

NPI: 1831165232
Provider Name (Legal Business Name): LINDA CRASKA SELBY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 W WASHINGTON ST
BURNS OR
97720-1441
US

IV. Provider business mailing address

557 W WASHINGTON ST
BURNS OR
97720-1441
US

V. Phone/Fax

Practice location:
  • Phone: 541-573-2074
  • Fax: 541-573-8893
Mailing address:
  • Phone: 541-573-7281
  • Fax: 541-573-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMD23626
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: