Provider Demographics
NPI:1144399304
Name:REPRODUCTIVE MEDICINE LABORATORY
Entity Type:Organization
Organization Name:REPRODUCTIVE MEDICINE LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:523-274-5439
Mailing Address - Street 1:2222 NW LOVEJOY ST STE 304
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5100
Mailing Address - Country:US
Mailing Address - Phone:503-274-4994
Mailing Address - Fax:503-274-4946
Practice Address - Street 1:2222 NW LOVEJOY ST STE 304
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5100
Practice Address - Country:US
Practice Address - Phone:503-274-4994
Practice Address - Fax:503-274-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory