Healthcare Provider Details

I. General information

NPI: 1386565729
Provider Name (Legal Business Name): MADISON ALEXANDRIA SETZER CRM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 NW 4TH ST
CORVALLIS OR
97330-6409
US

IV. Provider business mailing address

442 NW 4TH ST
CORVALLIS OR
97330-6409
US

V. Phone/Fax

Practice location:
  • Phone: 541-250-2462
  • Fax:
Mailing address:
  • Phone: 541-250-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number93-0931684
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: