Healthcare Provider Details

I. General information

NPI: 1730160540
Provider Name (Legal Business Name): OREGON OPEN MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHGATE STE 8
PENDLETON OR
97801-3974
US

IV. Provider business mailing address

2784 12TH ST SE
SALEM OR
97302-3159
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1142
  • Fax: 541-276-1143
Mailing address:
  • Phone: 877-630-9804
  • Fax: 503-586-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number971
License Number StateOR

VIII. Authorized Official

Name: MR. DONALD A ZUMMER
Title or Position: MANAGING PARTNER
Credential:
Phone: 877-630-9804