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General NPI Number Information
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NPI Number | 1326210063
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Entity Type | Organization
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Legal Business Name | PACIFIC OBSTETRICS & GYNECOLOGY, L.L.C.
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 700 BELLEVUE ST SE STE 210
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City | SALEM
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State | OR
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Zip | 97301-3855
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Country | US
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Telephone | 503-485-5959
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Fax | 503-485-5962
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Provider Business Mailing Address
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Address Line | PO BOX 2082
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City | PORTLAND
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State | OR
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Zip | 97208-2082
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Country | US
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Telephone | 503-356-9166
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Fax | 503-771-7221
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LAVENA MARIE MORGAN-JAHANSHIR
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Credential | M.D.
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Telephone | 503-485-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD21448
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License Number State | OR
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