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General NPI Number Information
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NPI Number | 1831324847
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Entity Type | Organization
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Legal Business Name | WILLAMETTE VALLEY RHEUMATOLGY PC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 06/10/2009
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Provider Practice Location Address
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Address Line | 402 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1831
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Country | US
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Telephone | 503-538-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 402 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1831
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. RAMON MACASA JR.
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Credential |
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Telephone | 503-840-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD26899
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License Number State | OR
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