Organization
OPEN ADVANCED MRI OF GRESHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEVENT ADAM (DIRECTOR OF OPERATIONS)
(703) 970-2892
Entity
Organization
Contact information
Practice address
1026 NW SLERET AVE, GRESHAM, OR 97030
(503) 489-1674
(503) 489-1678
Mailing address
DEPARTMENT 4888, CAROL STREAM, IL 60122-4888
(503) 657-8663
(503) 723-3180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286947
—
OR
05
—
7113541
—
WA
Enumeration date
05/25/2006
Last updated
01/03/2011
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