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10700 Sw Beaverton Hillsdale Hwy Bldg 3 Beaverton OR 97005-3019 | |
| (971) 803-0543 | |
| (971) 275-1479 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10700 Sw Beaverton Hillsdale Hwy Bldg 3, Beaverton, Oregon |
| Authorized Official Name and Position | Melanie Smith-thuret (OWNER) |
| Authorized Official Contact | 9718030543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
385 Nw 114th Ave Portland OR 97229-6129 Ph: (971) 803-0543 | 10700 Sw Beaverton Hillsdale Hwy Bldg 3 Beaverton OR 97005-3019 Ph: (971) 803-0543 |
| NPI Number | 1235895715 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 11/17/2021 |
| Certification Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235895715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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