Provider Demographics
NPI:1407492002
Name:OREGON INJECTION CLINIC
Entity Type:Organization
Organization Name:OREGON INJECTION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVES
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-305-4755
Mailing Address - Street 1:610 SW ALDER ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-3603
Mailing Address - Country:US
Mailing Address - Phone:503-305-4755
Mailing Address - Fax:503-305-4755
Practice Address - Street 1:1500 NW LOVEJOY
Practice Address - Street 2:106
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209
Practice Address - Country:US
Practice Address - Phone:503-305-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service