| Impact Of Oregon Llc | |
|
3539 Heathrow Way Ste 201 Medford OR 97504-4148 | |
| (503) 523-5605 | |
| Not Available |
| Full Name | Impact Of Oregon Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3539 Heathrow Way Ste 201, Medford, Oregon |
| Authorized Official Name and Position | Gina Bushey (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5035235605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Of Oregon Llc 3539 Heathrow Way Ste 201 Medford OR 97504-4148 Ph: (503) 523-5605 | Impact Of Oregon Llc 3539 Heathrow Way Ste 201 Medford OR 97504-4148 Ph: (503) 523-5605 |
| NPI Number | 1063377711 |
|---|---|
| Provider Enumeration Date | 12/16/2025 |
| Last Update Date | 12/16/2025 |
| Certification Date | 12/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063377711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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