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General NPI Number Information
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NPI Number | 1861762445
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Entity Type | Individual
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Provider Name | JAMES HAROLD VANOLST MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 136 SW WASHINGTON AVE #605
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City | CORVALLIS
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State | OR
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Zip | 97333-4672
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Country | US
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Telephone | 541-754-1636
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Fax | 541-754-6440
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Provider Business Mailing Address
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Address Line | 136 SW WASHINGTON AVE. #605
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City | CORVALLIS
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State | OR
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Zip | 97333-4879
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Country | US
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Telephone | 541-754-1636
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Fax | 541-754-6440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD06353
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License Number State | OR
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