Mary Beth Horrall, MD | |
15950 Sw Millikan Way, Beaverton, OR 97006 | |
(503) 646-0161 | |
(503) 643-7459 |
Full Name | Mary Beth Horrall |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 15950 Sw Millikan Way, Beaverton, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790876274 | NPI | - | NPPES |
005582 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD4098 (Oklahoma) | Secondary |
208000000X | Pediatrics | MD16301 (Oregon) | Primary |
Entity Name | Portland Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558379099 PECOS PAC ID: 8224942867 Enrollment ID: O20031118000101 |
Mailing Address | Practice Location Address |
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Mary Beth Horrall, MD 800 Sw 13th Ave, Portland, OR 97205-1902 Ph: (503) 221-0161 | Mary Beth Horrall, MD 15950 Sw Millikan Way, Beaverton, OR 97006 Ph: (503) 646-0161 |
Douglas Joseph Hamill, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4855 Sw Western Ave, Beaverton Medical Office, Beaverton, OR 97005 Phone: 503-643-7565 | |
Dr. Luanne Nilsen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4855 Sw Western Ave, Beaverton, OR 97005 Phone: 503-643-7565 | |
Dean A Moshofsky, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006 Phone: 503-534-3434 Fax: 503-645-4544 | |
Heather M Moore, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006 Phone: 503-531-3434 Fax: 503-645-4544 | |
Thomas Jeffrey Anderson Ii, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 15455 Nw Greenbrier Pkwy Ste 111, Beaverton, OR 97006 Phone: 503-531-3434 Fax: 503-645-4544 | |
Cole Julius Nygard, Pediatrics Medicare: Medicare Enrolled Practice Location: 15455 Nw Greenbrier Pkwy Ste 111, Beaverton, OR 97006 Phone: 503-531-3434 | |
Mary Ellen Ulmer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 15950 Sw Millikan Way, Beaverton, OR 97006 Phone: 503-646-0161 Fax: 503-643-7459 |