# LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.

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

## Provider details

- **NPI number:** 1407335979
- **Authorized official:** SARA SHOWERS (MEDICAL BILLING SPECIALIST LEAD)
- **Authorized official phone:** (805) 928-7361

## Contact information

- **Practice address:** 17175 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-4584
- **Practice address phone:** (805) 736-7886
- **Practice address fax:** (805) 736-7867
- **Mailing address:** 218 NORTH I STREET, LOMPOC, CA 93436
- **Mailing address phone:** (805) 736-7886
- **Mailing address fax:** (805) 736-7867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2018
- **Last updated:** 08/07/2018