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General NPI Number Information
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NPI Number | 1396837340
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Entity Type | Organization
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Legal Business Name | NORTHERN PACIFIC DIAGNOSTICS P C
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2865 DAGGETT AVE
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City | KLAMATH FALLS
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State | OR
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Zip | 97601-1106
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Country | US
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Telephone | 541-664-5151
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Fax | 541-664-5155
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Provider Business Mailing Address
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Address Line | 1208 BEALL LN
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City | CENTRAL POINT
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State | OR
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Zip | 97502-1573
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Country | US
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Telephone | 800-734-7486
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Fax | 877-772-9433
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIGUEL MONTES
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Credential |
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Telephone | 541-274-4049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 38D1000455
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License Number State | OR
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