Organization
GRANTS PASS IMAGING AND DIAGNOTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CLAGUE OEHLING MD (MEDICAL DIRECTOR)
(541) 472-5154
Entity
Organization
Contact information
Practice address
1619 NW HAWTHORNE AVE STE 204, GRANTS PASS, OR 97526-6009
(541) 472-5154
(541) 472-5178
Mailing address
1619 NW HAWTHORNE AVE STE 204, GRANTS PASS, OR 97526-6009
(541) 472-5154
(541) 472-5178
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170137
—
OR
Enumeration date
06/26/2006
Last updated
07/21/2022
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