Organization
OB GYN BREAST IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK LARSON (OFFICE MANAGER)
(503) 579-5000
Entity
Organization
Contact information
Practice address
17050 PILKINGTON RD, SUITE 130, LAKE OSWEGO, OR 97035-6306
(503) 579-5000
Mailing address
14780 SW OSPREY DR, SUITE 325, BEAVERTON, OR 97007-8028
(503) 579-5000
Taxonomy
Speciality
Code
Description
License number
State
2471M2300X
Mammography Radiologic Technologist
Primary
—
—
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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