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General NPI Number Information
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NPI Number | 1801834361
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Entity Type | Organization
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Legal Business Name | PATHOLOGY CONSULTANTS, PC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 123 INTERNATIONAL WAY
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City | SPRINGFIELD
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State | OR
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Zip | 97477
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Country | US
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Telephone | 541-341-8033
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Fax | 541-341-8099
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Provider Business Mailing Address
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Address Line | PO BOX 72059
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City | SPRINGFIELD
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State | OR
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Zip | 97475-0285
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Country | US
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Telephone | 541-222-6913
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Fax | 541-222-6908
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | JOYCE SIAMON
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Credential | MHSA
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Telephone | 541-341-8033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 38D1027898
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License Number State | OR
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