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Contact Information

OPEN ADVANCED MRI OF GRESHAM LLC
1026 NW SLERET AVE
GRESHAM, OR97030
 Phone: 503-489-1674
 Fax: 503-489-1678
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for OPEN ADVANCED MRI OF GRESHAM LLC · (Female)

NPI Number 1609822683
Status Active
Credentials
Entity Individual
Enumeration date 05/25/2006
Last updated 01/03/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR Medicaid 286947
  • WA Medicaid 7113541
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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