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General NPI Number Information
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NPI Number | 1992420194
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Entity Type | Organization
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Legal Business Name | OREGON VASCULAR AND VEIN INSTITUTE
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 1460 G ST STE 100
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4112
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Country | US
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Telephone | 541-988-6330
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Fax | 541-988-6340
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Provider Business Mailing Address
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Address Line | 1460 G ST STE 100
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4112
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Country | US
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Telephone | 541-988-6330
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Fax | 541-988-6341
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE VIRAMONTES JR.
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Credential |
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Telephone | 541-988-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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