Provider Demographics
NPI:1023167061
Name:DOWNEY, DARYL BRYCE (MD)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:BRYCE
Last Name:DOWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 NW GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4366
Mailing Address - Country:US
Mailing Address - Phone:541-758-5365
Mailing Address - Fax:
Practice Address - Street 1:2075 NW GRANT AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4366
Practice Address - Country:US
Practice Address - Phone:541-758-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR159022084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002315OtherCHAMPUS
ORJ3050OtherPACIFICSOURCE PIN
OR063172OtherOMAP
OR063172OtherOMAP
ORC61376Medicare UPIN