Healthcare Provider Details

I. General information

NPI: 1730575119
Provider Name (Legal Business Name): RISHI VORA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2015
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 BEVERLY ST STE B
SPRINGFIELD OR
97477-1910
US

IV. Provider business mailing address

2445 BEVERLY ST STE B
SPRINGFIELD OR
97477-1910
US

V. Phone/Fax

Practice location:
  • Phone: 541-780-6654
  • Fax:
Mailing address:
  • Phone: 541-780-6654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMTL003083
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberDO194550
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: