Organization
IMPACT OF OREGON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA BUSHEY (CHIEF OPERATING OFFICER)
(503) 523-5605
Entity
Organization
Contact information
Practice address
3539 HEATHROW WAY STE 201, MEDFORD, OR 97504-4148
(503) 523-5605
Mailing address
3539 HEATHROW WAY STE 201, MEDFORD, OR 97504-4148
(503) 523-5605
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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