Provider Demographics
NPI:1245276211
Name:OREGON SURGICAL CONSULTANTS PC
Entity type:Organization
Organization Name:OREGON SURGICAL CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-226-4325
Mailing Address - Street 1:1130 NW 22ND AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-226-4325
Mailing Address - Fax:503-227-5024
Practice Address - Street 1:1130 NW 22ND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210
Practice Address - Country:US
Practice Address - Phone:503-226-4325
Practice Address - Fax:503-227-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR124867Medicaid
OR0000WCGJKMedicare ID - Type Unspecified