Healthcare Provider Details

I. General information

NPI: 1407980477
Provider Name (Legal Business Name): OREGON IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 BELTLINE RD
SPRINGFIELD OR
97477-1091
US

IV. Provider business mailing address

PO BOX 25
EUGENE OR
97440-0025
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-7134
  • Fax: 541-334-6144
Mailing address:
  • Phone: 541-687-7134
  • Fax: 541-334-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: RICK REEVES
Title or Position: ADMINISTRATOR
Credential:
Phone: 541-687-7134