Organization
BEND MEMORIAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN LEIN (CEO)
(541) 317-4240
Entity
Organization
Contact information
Practice address
1541 NW CANAL BLVD, REDMOND, OR 97756-1341
(541) 382-2811
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213243
—
OR
Enumeration date
06/25/2008
Last updated
06/08/2009
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