Provider Demographics
NPI:1063642031
Name:ONCOLOGY ASSOCIATES OF OREGON P C PHYSICIANS
Entity Type:Organization
Organization Name:ONCOLOGY ASSOCIATES OF OREGON P C PHYSICIANS
Other - Org Name:WILLAMETTE VALLEY CANCER INSTITUTE AND RESEARCH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-736-3391
Mailing Address - Street 1:3377 RIVERBEND DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8800
Mailing Address - Country:US
Mailing Address - Phone:541-736-9931
Mailing Address - Fax:541-998-7933
Practice Address - Street 1:3377 RIVERBEND DR STE 500
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-736-9931
Practice Address - Fax:541-998-7933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRP-00025453336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3843629OtherNCPDP PROVIDER IDENTIFICATION NUMBER
OR191387Medicaid