| Amg Of Oregon Pc | |
|
5440 Sw Westgate Dr Ste 345 Portland OR 97221-2416 | |
| (888) 502-2292 | |
| (888) 505-1381 |
| Full Name | Amg Of Oregon Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5440 Sw Westgate Dr Ste 345, Portland, Oregon |
| Authorized Official Name and Position | Michael J Noonan (PRESIDENT) |
| Authorized Official Contact | 8885022291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amg Of Oregon Pc 4045 E Bell Rd Ste 157 Phoenix AZ 85032-2240 Ph: (602) 404-0015 | Amg Of Oregon Pc 5440 Sw Westgate Dr Ste 345 Portland OR 97221-2416 Ph: (888) 502-2292 |
| NPI Number | 1407443112 |
|---|---|
| Provider Enumeration Date | 12/29/2020 |
| Last Update Date | 12/29/2020 |
| Medicare PECOS PAC ID | 7911310719 |
|---|---|
| Medicare Enrollment ID | O20210707003069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407443112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Lisa M Enger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295983617 PECOS PAC ID: 9436207909 Enrollment ID: I20090512000048 |
| Provider Name | Michael J Noonan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1124166244 PECOS PAC ID: 0648169946 Enrollment ID: I20110315000284 |
| Provider Name | Joana Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538583471 PECOS PAC ID: 8527288109 Enrollment ID: I20141002000549 |
| Provider Name | Kyirsty J Bower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740679356 PECOS PAC ID: 6103230123 Enrollment ID: I20210202001578 |
| Provider Name | Somaly Sith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033618293 PECOS PAC ID: 5799103529 Enrollment ID: I20210715000611 |
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