# CENTRAL OREGON INTERNAL MEDICINE LLC

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

## Provider details

- **NPI number:** 1184439820
- **Authorized official:** MR. MATTHEW JAN INGRASSIA DO (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (541) 728-2114

## Contact information

- **Practice address:** 2275 NE DOCTORS DR STE 7, BEND, OR 97701-6324
- **Practice address phone:** (541) 728-2114
- **Practice address fax:** (541) 749-2126
- **Mailing address:** 2275 NE DOCTORS DR STE 7, BEND, OR 97701-6324
- **Mailing address phone:** (541) 728-2114
- **Mailing address fax:** (541) 749-2126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2025
- **Last updated:** 04/14/2025