| |
1934 Ne Broadway St Portland OR 97232-1502 | |
(503) 280-9759 | |
(503) 280-9798 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 1934 Ne Broadway St, Portland, Oregon |
Authorized Official Name and Position | Dana Sibilla (DIRECTOR) |
Authorized Official Contact | 5032809759 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1934 Ne Broadway St Portland OR 97232-1502 Ph: (503) 280-9759 | 1934 Ne Broadway St Portland OR 97232-1502 Ph: (503) 280-9759 |
NPI Number | 1558529560 |
---|---|
Provider Enumeration Date | 05/27/2008 |
Last Update Date | 05/27/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558529560 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 27-2971 (Oregon) | Primary |
Woodstock Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Se Woodstock Blvd, Portland, OR 97206 Phone: 503-236-1830 Fax: 503-236-1908 | |
Internal Medicine Consultants, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9585 Sw Washington Square Rd, Portland, OR 97223 Phone: 503-320-2121 Fax: 503-641-4158 | |
Jenna Halbert, Nd Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Ne Russell St Ste 207, Portland, OR 97212 Phone: 503-482-8301 | |