MEDICARE: DR. JOSEPH JEFFREY HABERMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD16023	OR
2	2085R0202X	Diagnostic Radiology Physician	D0044345	MD

General Provider Information

NPI Number	:	1740368695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH JEFFREY HABERMAN MD

Provider Business Mailing Address
First Line	:	6430 NW SISTERS PL
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97330-9243
Country	:	US
Telephone Number	:	541-745-5555
Fax Number	:	541-745-5557

Provider Business Practice Location Address
First Line	:	233 NE 102ND AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220
Country	:	US
Telephone Number	:	503-253-1105
Fax Number	:	503-535-8398

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	12/01/2025

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