Organization
HORIZON PROSTHETIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JANSEN CP (OWNER / CP)
(503) 626-3163
Entity
Organization
Contact information
Practice address
8033 SW CIRRUS DR BLDG 21F, BEAVERTON, OR 97008-5983
(503) 626-3163
(503) 626-6224
Mailing address
8033 SW CIRRUS DR BLDG 21F, BEAVERTON, OR 97008-5983
(503) 626-3163
(503) 626-6224
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
11765413
OR
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020594000
PACIFICARE
OR
05
—
181578
—
OR
01
—
816064000
REGENCE BLUE CROSS BLUE S
OR
Enumeration date
05/10/2006
Last updated
09/08/2017
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