Organization
LSVIV MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE J CADDY MD (OWNER/PRESIDENT)
(503) 372-2740
Entity
Organization
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 768-5111
Mailing address
8905 SW NIMBUS AVE, STE 300, BEAVERTON, OR 97008-7136
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD12078
OR
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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