Individual provider · Type 1 NPI

Tristan McKibben

Student in an Organized Health Care Education/Training Program · Corvallis, OR

NPI number 1083404420 Active

Practice location

1601 SW Jefferson Ave
Corvallis, OR 97331-8656

Call (541) 737-3424 Map

Mailing address

PO Box 70723
Springfield, OR 97475-0135

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XPI-0014268 (OR)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1083404420

Tristan McKibben's National Provider Identifier is 1083404420, issued on May 8, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Corvallis, OR. The record was last updated on May 8, 2025.