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110 Beavercreek Rd Ste 100 Oregon City OR 97045-4307 | |
(503) 655-8471 | |
(503) 655-8595 |
Full Name | |
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Speciality | Clinic/Center |
Location | 110 Beavercreek Rd Ste 100, Oregon City, Oregon |
Authorized Official Name and Position | Ed Johnson (CFO) |
Authorized Official Contact | 5037425325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2051 Kaen Rd Suite 367 Oregon City OR 97045-4035 Ph: (503) 742-5300 | 110 Beavercreek Rd Ste 100 Oregon City OR 97045-4307 Ph: (503) 655-8471 |
NPI Number | 1720017809 |
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Provider Enumeration Date | 07/01/2006 |
Last Update Date | 09/24/2019 |
Medicare PECOS PAC ID | 9537065560 |
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Medicare Enrollment ID | O20080912000100 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720017809 | NPI | - | NPPES |
022710 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Oregon City Family Practice Clinic,p.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1420 John Adams St, Oregon City, OR 97045 Phone: 503-656-1484 Fax: 503-650-1976 | |
24 On Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Division St, Oregon City, OR 97045 Phone: 503-656-1631 | |
Samuel Sabo Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18171 Waldow Rd, Oregon City, OR 97045 Phone: 503-655-6044 Fax: 503-575-9171 | |