Provider Demographics
NPI:1114362126
Name:WOMENS IMAGING AND INTERVENTION, LLC
Entity Type:Organization
Organization Name:WOMENS IMAGING AND INTERVENTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:THURMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-539-4766
Mailing Address - Street 1:17050 PILKINGTON RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-6306
Mailing Address - Country:US
Mailing Address - Phone:503-305-5432
Mailing Address - Fax:503-305-7294
Practice Address - Street 1:17050 PILKINGTON RD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-6306
Practice Address - Country:US
Practice Address - Phone:503-305-5432
Practice Address - Fax:503-305-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR93074194261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology