Provider Demographics
NPI:1922585314
Name:OREGON MEDICAL CENTERS LLC
Entity Type:Organization
Organization Name:OREGON MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-390-1552
Mailing Address - Street 1:2515 LIBERTY ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-8386
Mailing Address - Country:US
Mailing Address - Phone:503-390-1552
Mailing Address - Fax:503-393-3784
Practice Address - Street 1:2515 LIBERTY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-8386
Practice Address - Country:US
Practice Address - Phone:503-390-1552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
OR201804939NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty