Provider Demographics
NPI:1881639722
Name:LANDAUER, JANET LEAH (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEAH
Last Name:LANDAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 NW SAMARITAN DR
Mailing Address - Street 2:SUITE 1W001B
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3737
Mailing Address - Country:US
Mailing Address - Phone:541-768-6734
Mailing Address - Fax:541-768-6741
Practice Address - Street 1:3600 NW SAMARITAN DR
Practice Address - Street 2:SUITE 1W001B
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3737
Practice Address - Country:US
Practice Address - Phone:541-768-6734
Practice Address - Fax:541-768-6741
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287247Medicaid
OR287247Medicaid
OR133476Medicare ID - Type Unspecified