Provider Demographics
NPI:1669518049
Name:GOESER, CHRISTOPHER DILLON (MD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DILLON
Last Name:GOESER
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:PO BOX 2847
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:698 12TH ST SE STE 145
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4076
Practice Address - Country:US
Practice Address - Phone:503-588-2674
Practice Address - Fax:503-586-1301
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD216562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134058Medicaid
OR106693Medicare PIN