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General NPI Number Information
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NPI Number | 1104634252
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Entity Type | Organization
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Legal Business Name | OREGON SONOGRAPHY LLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 701 N 5TH ST
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City | LEBANON
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State | OR
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Zip | 97355-9559
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Country | US
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Telephone | 541-409-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 25125 MCCLUN RD
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City | SWEET HOME
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State | OR
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Zip | 97386-9624
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Country | US
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Telephone | 541-409-1983
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Fax |
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Authorized Official
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Title or Position | SONOGRAPHER
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Name | SUNDEE M HOFFMAN
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Credential | RVT, RDMS
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Telephone | 541-409-1983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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