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Contact Information

PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC
217 DIVISION AVE
EUGENE, OR97404-5429
 Phone: 541-686-3791
 Fax: 541-686-3795
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for PACIFIC SPORTS AND INTERVENTIONAL SPINE LLC · (Female)

NPI Number 1881186336
Status Active
Credentials
Entity Individual
Enumeration date 05/31/2018
Last updated 11/06/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # MD27887
  • OR License # MD28629
  • OR License # PA00420
  • OR License # PA00800
  • OR License # PA152998
  • OR Medicaid 244117
  • OR Medicaid 500604467
  • OR Medicaid 500608609
  • OR Medicaid 500624453
  • OR Medicaid 500632183
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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