Amavisca, Joseph Albert

Amavisca, Joseph Albert is an sole proprietor health care provider with primary practice located at 19250 Sw 65Th Ave Ste 250 , Tualatin OR 97062-7745. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Amavisca, Joseph Albert can be contacted via phone (503) 808-9213.

Contact Information

Primary practice address
19250 Sw 65Th Ave Ste 250 Tualatin OR 97062-7745
Phone: (503) 808-9213
Fax: (971) 346-4465
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X New Jersey
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD156341 Oregon

Profile Details

NPI number 1316178189
LBN Legal business name Amavisca, Joseph Albert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2009
Last updated Jan 6th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316178189 NPPES
Oregon MEDICAID 500672860

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