Healthcare Provider Details

I. General information

NPI: 1417967084
Provider Name (Legal Business Name): LINDA CHRISTENSEN DEACON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA SUE CHRISTENSEN PRICE MD

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N 5TH ST STE 200
LEBANON OR
97355-2875
US

IV. Provider business mailing address

PO BOX 1193
CORVALLIS OR
97339-1193
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-6282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG77800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD174218
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: