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General NPI Number Information
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NPI Number | 1881730554
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Entity Type | Individual
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Provider Name | ERIN KELLY COOLEY M.D., F.A.C.S.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 3620 NW SAMARITAN DR STE 201
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City | CORVALLIS
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State | OR
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Zip | 97330-3785
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Country | US
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Telephone | 541-768-6300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1189
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City | CORVALLIS
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State | OR
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Zip | 97339-1189
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 229226
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 29237
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | MD175774
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License Number State | OR
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