Organization
OREGON ADVANCED IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE K GUNDLACH (BOOKKEEPER)
(541) 608-8791
Entity
Organization
Contact information
Practice address
545 MEDICAL CENTER DR, MEDFORD, OR 97504
(541) 773-8661
(541) 842-9206
Mailing address
PO BOX 1527, MEDFORD, OR 97501-0114
(541) 773-8661
(541) 842-9206
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100183
—
OR
Enumeration date
06/05/2008
Last updated
06/05/2008
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