Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jill M Provaznik, MD

Individual provider Internal Medicine Physician · NPI 1992185995

Jill M Provaznik, MD is an Internal Medicine in Corvallis, Oregon. Graduated from University of Arkansas College of Medicine in 2015, 11 years ago. Practices with Good Samaritan Hospital Corvallis, a 375-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Utah.

Years since qualifying
11
Trained at
University of Arkansas College of Medicine
Licensed in
OR, UT
In the registry since
2015
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3640 NW Samaritan Dr Ste 210
Corvallis, OR 97330-3787
Phone: (541) 768-5810
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 9205 Sw Barnes Rd, Portland, OR 97225-6603 — (503) 216-2906
  • 30 N 1900 E Rm 4b319, Salt Lake City, UT 84132-0002 — (801) 581-8812

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence MD189615 (OR)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD189615 (OR)
Infectious Disease Physician Taxonomy 207RI0200X · Licence 11262304-1205 (UT)

Record details

NPI number1992185995
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 4, 2015
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023
Mailing addressPo Box 1189, Corvallis, OR 97339-1189

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Good Samaritan Hospital Corvallis — 375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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