| Eric C Rysenga, MD | |
|
351 Sw 9th St, Ontario, OR 97914-2639 | |
| (541) 881-5331 | |
| Not Available |
| Full Name | Eric C Rysenga |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 351 Sw 9th St, Ontario, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659319549 | NPI | - | NPPES |
| 075122 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD18734 (Oregon) | Primary |
| Entity Name | Saint Alphonsus Medical Center Baker City Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881726206 PECOS PAC ID: 4981732518 Enrollment ID: O20100618000209 |
| Entity Name | Saint Alphonsus Medical Center- Ontario Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093034159 PECOS PAC ID: 1456488899 Enrollment ID: O20100713000593 |
| Mailing Address | Practice Location Address |
|---|---|
| Eric C Rysenga, MD Po Box 9589, Boise, ID 83707-4589 Ph: (208) 472-8120 | Eric C Rysenga, MD 351 Sw 9th St, Ontario, OR 97914-2639 Ph: (541) 881-5331 |
William C Thompson, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 351 Sw 9th St, Ontario, OR 97914 Phone: 541-881-5331 | |
Kathleen M Harms, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 351 Sw 9th St, Ontario, OR 97914 Phone: 541-881-5331 |