# ELITE INTERVENTIONAL RADIOLOGY CONSULTANTS OF OREGON PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083590533
- **Authorized official:** JACLYN EVANS (EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (727) 480-2734

## Contact information

- **Practice address:** 600 NW 11TH ST STE E10, HERMISTON, OR 97838-8602
- **Practice address phone:** (541) 667-3825
- **Mailing address:** 12421 SW SHERI AVE, LAKE SUZY, FL 34269-5938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/12/2025
- **Last updated:** 08/14/2025