Provider Demographics
NPI:1225720188
Name:LORANGER, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LORANGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 HANNON RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524-9598
Mailing Address - Country:US
Mailing Address - Phone:541-826-3070
Mailing Address - Fax:541-826-3080
Practice Address - Street 1:11500 HANNON RD
Practice Address - Street 2:
Practice Address - City:EAGLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97524-9598
Practice Address - Country:US
Practice Address - Phone:541-826-3070
Practice Address - Fax:541-826-3080
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6656183700000X
156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No183700000XPharmacy Service ProvidersPharmacy Technician