Healthcare Provider Details

I. General information

NPI: 1487609426
Provider Name (Legal Business Name): M. R . IMAGING ASSOCIATES LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 N 16TH ST SUITE 10
SPRINGFIELD OR
97477-4175
US

IV. Provider business mailing address

960 N 16TH ST SUITE 10
SPRINGFIELD OR
97477-4175
US

V. Phone/Fax

Practice location:
  • Phone: 541-726-4959
  • Fax: 541-741-2188
Mailing address:
  • Phone: 541-726-4959
  • Fax: 541-741-2188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LYN GAMBLE
Title or Position: OFFICE MANAGER
Credential:
Phone: 541-726-4959