# LSVIV MEDICAL PC

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

## Provider details

- **NPI number:** 1487084281
- **Authorized official:** LANCE J CADDY MD (OWNER/PRESIDENT)
- **Authorized official phone:** (503) 372-2740

## Contact information

- **Practice address:** 3600 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
- **Practice address phone:** (541) 768-5111
- **Mailing address:** 8905 SW NIMBUS AVE, STE 300, BEAVERTON, OR 97008-7136
- **Mailing address phone:** (503) 372-2740
- **Mailing address fax:** (503) 372-2754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | MD12078 | OR | Yes |

## Other

- **Enumeration date:** 11/15/2013
- **Last updated:** 11/15/2013