Willamette General & Colon-Rectal Surgery Pc

LBN: Willamette General & Colon-Rectal Surgery Pc
Willamette General & Colon-Rectal Surgery Pc is an health care organization with primary practice located at 19875 Sw 65Th Ave Suite 260, Tualatin OR 97062-8353. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Willamette General & Colon-Rectal Surgery Pc can be contacted via phone (503) 691-1743, or through Evetts, Brent K via phone (503) 691-1743.

Contact Information

Primary practice address
19875 Sw 65Th Ave Suite 260 Tualatin OR 97062-8353
Fax: (503) 691-0983
Website:
Authorized official contact:
Name: Evetts, Brent K Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD20653 Oregon

Profile Details

NPI number 1396736518
LBN Legal business name Willamette General & Colon-Rectal Surgery Pc
DBA Doing business as
Authorized official Evetts, Brent K Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 4th, 2005
Last updated Sep 9th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396736518 NPPES
Oregon Other R105002 MEDICARE PTAN
Oregon MEDICAID 150330 MEDICARE PTAN
Oregon Other 1375470 MEDICARE PTAN
Oregon Other 000035001 MEDICARE PTAN
Oregon Other 3007286-01 MEDICARE PTAN

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