Healthcare Provider Details

I. General information

NPI: 1700973476
Provider Name (Legal Business Name): CHRISTINE ELIZABETH RIVERS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2397 NW KINGS BLVD # 4022
CORVALLIS OR
97330-3986
US

IV. Provider business mailing address

2397 NW KINGS BLVD # 4022
CORVALLIS OR
97330-3986
US

V. Phone/Fax

Practice location:
  • Phone: 541-224-7995
  • Fax: 541-325-4076
Mailing address:
  • Phone: 541-224-7995
  • Fax: 541-325-4076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO153927
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOP00001944
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: