Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 27480 | OR |
NPI | 1073600938 |
---|---|
Provider Name | Dr. Jose Viramontes JR. |
First Address | Springfield, OR 97477-4175 |
Second Address | Springfield, OR 97477-4175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 26/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006389 | (05) | OR |