Provider Demographics
NPI:1861762445
Name:VANOLST, JAMES HAROLD (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HAROLD
Last Name:VANOLST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:136 SW WASHINGTON AVE.
Mailing Address - Street 2:#605
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4879
Mailing Address - Country:US
Mailing Address - Phone:541-754-1636
Mailing Address - Fax:541-754-6440
Practice Address - Street 1:136 SW WASHINGTON AVE
Practice Address - Street 2:#605
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4672
Practice Address - Country:US
Practice Address - Phone:541-754-1636
Practice Address - Fax:541-754-6440
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD06353207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery