Provider Demographics
NPI:1952504540
Name:SLOUGH, CRISTIAN MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:MARTIN
Last Name:SLOUGH
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 1:2700 SE STRATUS AVE.
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6239
Mailing Address - Country:US
Mailing Address - Phone:503-434-1110
Mailing Address - Fax:503-434-1119
Practice Address - Street 1:2700 SE STRATUS AVE.
Practice Address - Street 2:SUITE 402
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6239
Practice Address - Country:US
Practice Address - Phone:503-434-1110
Practice Address - Fax:503-434-1119
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD151166207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology