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Icco Llc
Medical Physician Assistant in Eugene, Oregon
NPI 1700251154

Icco Llc is a Medical Physician Assistant based in Eugene, OR and is specialized in Medical. Icco Llc practices in Eugene, OR. The NPI Number for Icco Llc is 1700251154 and holds a License No. PA175527 (Oregon).

The current practice location address for Icco Llc is 1292 High Street, Eugene, OR and can be reached out via phone at 541-345-8760 and via fax at 541-345-8763.

Location: 1292 High Street, Eugene, OR, 97401-3238
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700251154
Provider Name
Icco Llc
Credential
Provider Entity Type
Organization
Address
1292 High Street, Eugene, OR, 97401-3238
Phone Number
541-345-8760
Fax Number
541-345-8763
Provider Enumeration Date
12/10/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA175527 01 OR OREGON MEDICAL BOARD STATE LICENSE FOR PHYSICIAN ASSISTANT
institution
Provider Business Practice Location Address Details
Address
1292 High Street
City
Eugene
State
Oregon
Zip
97401
Phone Number
541-345-8760
Fax Number
541-345-8763
person
Provider Business Mailing Address Details
Address
1292 High Street
City
Eugene
State
Oregon
Zip
97401
Phone Number
541-345-8760
Fax Number
541-345-8763
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA175527 (Oregon)
Definition
Definition to come...
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