Provider Demographics
NPI:1710115365
Name:OREGON SLEEP CENTER
Entity Type:Organization
Organization Name:OREGON SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARISIC
Authorized Official - Suffix:
Authorized Official - Credentials:PSGT
Authorized Official - Phone:541-667-4104
Mailing Address - Street 1:1050 W ELM AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-2700
Mailing Address - Country:US
Mailing Address - Phone:541-667-4104
Mailing Address - Fax:541-667-4175
Practice Address - Street 1:1050 W ELM AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2700
Practice Address - Country:US
Practice Address - Phone:541-667-4104
Practice Address - Fax:541-667-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic