Provider Demographics
NPI:1720024912
Name:FOREMAN, CHELSEA L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:L
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1115 JACKSON ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-3245
Mailing Address - Country:US
Mailing Address - Phone:541-812-9216
Mailing Address - Fax:541-917-6676
Practice Address - Street 1:1115 JACKSON ST SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-3245
Practice Address - Country:US
Practice Address - Phone:541-812-9216
Practice Address - Fax:541-917-6676
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD19841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORG30751Medicare UPIN