DR. AGATHA SONG
NPI 1992925507
Specialist in Roseburg, OR

Q: What is Agatha Song's NPI number?

The NPI number for Agatha Song is 1992925507. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Q: What is Agatha Song's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Agatha Song was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2007PECOS Enrolled

913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97470(541) 440-1377(541) 440-1394 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Agatha Song NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AGATHA SONG (NPI 1992925507) is an individual specialist in Roseburg, Oregon, licensed in New Jersey (25MA04557700) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992925507

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameDR. AGATHA SONG

Location Address913 NW GARDEN VALLEY BLVDRoseburg, OR 97470-6523

Mailing Address1450 Nw Mulholland Dr, # 156Roseburg, OR 97470-1942 · (620) 802-1220 · Fax (541) 673-0901

Phone(541) 440-1377

Fax(541) 440-1394

Sole ProprietorYes

Enumeration DateApril 26, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1992925507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in NJ · 25MA04557700

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

913 NW GARDEN VALLEY BLVD, Roseburg, OR 97470

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Other Identifiers 1

Medicare UPINF42525NJ

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Agatha Song is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VA ROSEBURG HEALTHCARE SYSTEM

Psychiatric Hospital

913 NW GARDEN VALLEY BLVD
ROSEBURG, OR 97470

Douglas County (541) 440-1000

DR. ROGER STUART BOTHWELL M.D.

Surgery

913 NW GARDEN VALLEY BLVD
ROSEBURG, OR 97470

Douglas County (541) 440-1000

MS. JO ANN G. BERENBACH PMHNP

Nurse Practitioner (Psychiatric/Mental Health)

913 NW GARDEN VALLEY BLVD, BUILDING 2 MHC
ROSEBURG, OR 97470

Douglas County (541) 440-1000

DR. LUUL - GHEBREDNGHIL M.D.

Internal Medicine

913 NW GARDEN VALLEY BLVD
ROSEBURG, OR 97470

Douglas County (541) 440-1000

MATTHEW LYNDON JAMES RPH

Pharmacist

913 NW GARDEN VALLEY BLVD
ROSEBURG, OR 97470

Douglas County (541) 440-1000

JOHN MCCAFFREY M.D.

Radiology (Diagnostic Radiology)

913 NW GARDEN VALLEY BLVD
ROSEBURG, OR 97470

Douglas County (541) 440-1000

MS. MARY L GARVEY M.S. PHARM

Pharmacist

913 NW GARDEN VALLEY BLVD, VA ROSEBURG HEALTH CARE SYSTEM PHARMACY DEPT.
ROSEBURG, OR 97470

Douglas County (541) 440-1000

VETERANS AFFAIRS

Rehabilitation, Substance Use Disorder Unit

913 NW GARDEN VALLEY BLVD, WARD 2, BLDG 2, SARTP
ROSEBURG, OR 97470

Douglas County (541) 440-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Agatha Song's NPI number?

The NPI number for Agatha Song is 1992925507. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Where is Agatha Song located?

Agatha Song practices at 913 NW Garden Valley Blvd, Roseburg, OR 97470. The listed phone number is (541) 440-1377.

What is Agatha Song's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Agatha Song enrolled in Medicare?

Yes. Agatha Song is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Agatha Song was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.