Organization
MCKENZIE MEDICAL IMAGING PC
Active
Other names
Willamette Valley Mammography
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI L BRIDGES (OFFICE MANAGER)
(541) 726-4699
Entity
Organization
Contact information
Practice address
960 N 16TH ST, SUITE 105, SPRINGFIELD, OR 97477-4175
(541) 726-4699
(541) 744-6069
Mailing address
960 N 16TH ST, SUITE 105, SPRINGFIELD, OR 97477-4175
(541) 726-4699
(541) 744-6069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018382
—
OR
01
—
C03559
RAILROAD MEDICARE
OR
Enumeration date
06/11/2006
Last updated
05/21/2009
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