1427170125 NPI number — WASHINGTON COUNTY PATHOLOGISTS PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427170125 NPI number — WASHINGTON COUNTY PATHOLOGISTS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON COUNTY PATHOLOGISTS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427170125
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
335 SE 8TH AVENUE
Provider Second Line Business Mailing Address:
WASHINGTON COUNTY PATHOLOGISTS PC
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97123-4248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-681-1147
Provider Business Mailing Address Fax Number:
503-681-1903

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
335 SE 8TH AVENUE
Provider Second Line Business Practice Location Address:
WASHINGTON COUNTY PATHOLOGISTS PC
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97123-4248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-681-1147
Provider Business Practice Location Address Fax Number:
503-681-1903
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
URSTADT
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
DIANNE STOVALL
Authorized Official Title or Position:
WCP PRESIDENT
Authorized Official Telephone Number:
503-681-1147

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 053756 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com