Healthcare Provider Details

I. General information

NPI: 1679362198
Provider Name (Legal Business Name): THE CORVALLIS CLINIC P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 NW SAMARITAN DR STE 100
CORVALLIS OR
97330-3737
US

IV. Provider business mailing address

444 NW ELKS DR
CORVALLIS OR
97330-3745
US

V. Phone/Fax

Practice location:
  • Phone: 541-754-1282
  • Fax: 541-967-0054
Mailing address:
  • Phone: 702-480-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. EMILY CASTILLO
Title or Position: DIRECTOR
Credential:
Phone: 702-480-2550