Vining, Jack

Vining, Jack is an individual health care provider with primary practice located at 2700 Se Stratus Ave , Mcminnville OR 97128-6255. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Vining, Jack can be contacted via phone (503) 472-6131.

Contact Information

Primary practice address
2700 Se Stratus Ave Mcminnville OR 97128-6255
Phone: (503) 472-6131
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD12819 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD12819 Oregon

Profile Details

NPI number 1922041920
LBN Legal business name Vining, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 28th, 2007 - about 17 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 1922041920 NPPES
Washington MEDICAID 8378382
Washington Other JM9451
Washington Other 97128A002
Washington Other D86802
Washington Other 0190386
Washington MEDICAID 261156
Washington Other D86802
Washington MEDICAID XPY185640
Washington Other P00333023

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