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General NPI Number Information
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NPI Number | 1952529620
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Entity Type | Organization
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Legal Business Name | CORVALLIS MRI A JOINT VENTURE
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 3615 NW SAMARITAN DRIVE SUITE 101
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City | CORVALLIS
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State | OR
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Zip | 97330-3737
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Country | US
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Telephone | 541-768-5187
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Fax | 541-768-5092
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Provider Business Mailing Address
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Address Line | 3600 NW SAMARITAN DRIVE
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City | CORVALLIS
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State | OR
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Zip | 97330-3737
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Country | US
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Telephone | 541-768-5187
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. BECKY A. PAPE
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Credential |
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Telephone | 541-768-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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