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General NPI Number Information
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NPI Number | 1336705557
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Entity Type | Organization
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Legal Business Name | OREGON SPECIAL SURGERY CENTER
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 2785 RIVER RD S
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City | SALEM
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State | OR
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Zip | 97302-5883
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Country | US
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Telephone | 503-881-9459
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Fax | 503-363-4373
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Provider Business Mailing Address
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Address Line | 2480 LIBERTY ST NE STE 180
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City | SALEM
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State | OR
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Zip | 97301-8388
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Country | US
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Telephone | 503-881-9459
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Fax | 503-363-4373
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | CHONTHICHA CHEN
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Credential |
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Telephone | 503-881-9459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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