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NPI Code Detail

MEDICARE: GASTROENTEROLOGY SPECIALISTS OF OREGON PC

MEDICARE: GASTROENTEROLOGY SPECIALISTS OF OREGON PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164464616
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTROENTEROLOGY SPECIALISTS OF OREGON PC
Provider Business Mailing Address
First Line : 1508 DIVISION ST
Second Line : SUITE 15
City : OREGON CITY
State : OR
Zip : 97045-1583
Country : US
Telephone Number : 503-657-5555
Fax Number : 503-657-6502
Provider Business Practice Location Address
First Line : 1508 DIVISION ST
Second Line : SUITE 15
City : OREGON CITY
State : OR
Zip : 97045-1583
Country : US
Telephone Number : 503-657-5555
Fax Number : 503-657-6502
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : BARBARA G TAUSCHER
Credential :
Telephone Number : 971-224-2457
Provider Enumeration Date : 06/11/2006
Last Update Date : 09/13/2007

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Directions to “GASTROENTEROLOGY SPECIALISTS OF OREGON PC ” Practice Location

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