| NPI | 1518103274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA RAYLENE VAN DIS Credentialing Coordinator 541-677-4319 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RS0012X Internal Medicine, Sleep Medicine | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 208800000X Urology | |
| 208M00000X Hospitalist | |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2019-11-25 |