Organization
THE VASCULAR AND INTERVENTIONAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY BOUSCHOR (ADMINISTRATOR)
(503) 612-0498
Entity
Organization
Contact information
Practice address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(503) 612-0498
(503) 459-0521
Mailing address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(503) 612-0498
(503) 459-0521
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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