Organization
ONTARIO PATHOLOGY GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC RYSENGA M.D. (PARTNER)
(541) 881-5331
Entity
Organization
Contact information
Practice address
351 S.W. NINTH ST., ONTARIO, OR 97914
(541) 881-5331
Mailing address
PO BOX 9589, BOISE, ID 83707-4589
(208) 472-8120
(208) 344-1926
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287920
—
OR
Enumeration date
07/04/2006
Last updated
08/26/2007
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