Organization
BLUE MOUNTAIN PATHOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE J ADAMS MD (PRESIDENT OF COMPANY)
(541) 966-1184
Entity
Organization
Contact information
Practice address
434 SE 3RD STREET, PENDLETON, OR 97801
(541) 966-1184
(541) 278-9365
Mailing address
PO BOX 1049, PENDLETON, OR 97801-0050
(541) 966-1184
(541) 278-9365
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2618
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028733
—
OR
01
—
083931000
BLUE CROSS BLUE SHIELD
OR
05
—
7032782
—
WA
01
—
CN2826
RR MEDICARE
—
Enumeration date
06/19/2006
Last updated
12/02/2014
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