Organization
ELITE INTERVENTIONAL RADIOLOGY CONSULTANTS OF OREGON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN EVANS (EXECUTIVE ADMINISTRATOR)
(727) 480-2734
Entity
Organization
Contact information
Practice address
600 NW 11TH ST STE E10, HERMISTON, OR 97838-8602
(541) 667-3825
Mailing address
12421 SW SHERI AVE, LAKE SUZY, FL 34269-5938
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
08/12/2025
Last updated
08/14/2025
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