Provider Demographics
NPI:1710029889
Name:OREGON PSYCHIATRIC PARTNERS LLP
Entity Type:Organization
Organization Name:OREGON PSYCHIATRIC PARTNERS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:TELEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-726-9912
Mailing Address - Street 1:3203 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3348
Mailing Address - Country:US
Mailing Address - Phone:541-726-9912
Mailing Address - Fax:541-744-4443
Practice Address - Street 1:3203 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3348
Practice Address - Country:US
Practice Address - Phone:541-726-9912
Practice Address - Fax:541-744-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101312Medicare ID - Type UnspecifiedGROUP NUMBER