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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

NPI # 1609822683
LBN Legal business name OPEN ADVANCED MRI OF GRESHAM LLC
Authorized official LEVENT ADAM - (DIRECTOR OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 05/25/2006
Last updated 01/03/2011 - About 15 years ago
Identifiers
OR Medicaid 286947
WA Medicaid 7113541
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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