Healthcare Provider Details

I. General information

NPI: 1871535021
Provider Name (Legal Business Name): THERESA J CURRAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 NE WEST DEVILS LAKE RD
LINCOLN CITY OR
97367-5127
US

IV. Provider business mailing address

PO BOX 1194
CORVALLIS OR
97339-1194
US

V. Phone/Fax

Practice location:
  • Phone: 541-994-9191
  • Fax: 541-994-9034
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01066
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: