Healthcare Provider Details

I. General information

NPI: 1245327121
Provider Name (Legal Business Name): ONCOLOGY ASSOCIATES OF OREGON P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 COUNTRY CLUB PKWY
EUGENE OR
97401-6043
US

IV. Provider business mailing address

520 COUNTRY CLUB PKWY
EUGENE OR
97401-6043
US

V. Phone/Fax

Practice location:
  • Phone: 541-681-4948
  • Fax: 541-338-0802
Mailing address:
  • Phone: 541-681-4948
  • Fax: 541-338-0802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP0001641CS
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier191387
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer
# 2
Identifier2078847
Identifier TypeOTHER
Identifier State
Identifier IssuerPK

VIII. Authorized Official

Name: BETH DALISKY
Title or Position: DIRECTOR OF PHARMACY
Credential: RPH
Phone: 541-681-4948