Mr Michael E Wilson, DO | |
12360 Se Sunnyside Rd, Clackamas, OR 97015-9320 | |
(503) 659-4988 | |
(503) 698-4018 |
Full Name | Mr Michael E Wilson |
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Gender | Male |
Speciality | Family Medicine |
Location | 12360 Se Sunnyside Rd, Clackamas, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629052238 | NPI | - | NPPES |
P00036570 | Other | OR | RR MEDICARE |
079983 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | DO18900 (Oregon) | Primary |
Entity Name | Northwest Primary Care Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144319658 PECOS PAC ID: 0244125052 Enrollment ID: O20040219000947 |
Mailing Address | Practice Location Address |
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Mr Michael E Wilson, DO Po Box 22075, Milwaukie, OR 97269-2075 Ph: (503) 659-4777 | Mr Michael E Wilson, DO 12360 Se Sunnyside Rd, Clackamas, OR 97015-9320 Ph: (503) 659-4988 |
Dr. Calvert John Shipley, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9800 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-653-6440 | |
Dr. Thorsten Lundsgaarde, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 | |
Dr. Lisa Burton, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9800 Se Sunnyside Rd, Mt Scott Medical Office, Clackamas, OR 97015 Phone: 503-652-2880 | |
Jon Peters, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 10151 Se Sunnyside Rd Ste 100, Clackamas, OR 97015 Phone: 503-659-0880 Fax: 503-513-7425 | |
Carla Jean Bowman, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 Fax: 503-571-8445 | |
Dr. Benjamin Jacob Colburn, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 10100 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-494-8211 | |
Guy Whitehead Iii, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 |