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3600 N Interstate Ave Portland OR 97227-1106 | |
(503) 528-7458 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 3600 N Interstate Ave, Portland, Oregon |
Authorized Official Name and Position | Stephen Shawn Barton (EXECUTIVE DIRECTOR, REVENUE CYCLE) |
Authorized Official Contact | 5038132440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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500 Ne Multnomah St Portland OR 97232-2023 Ph: (503) 813-4939 | 3600 N Interstate Ave Portland OR 97227-1106 Ph: (503) 528-7458 |
NPI Number | 1285960732 |
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Provider Enumeration Date | 10/19/2009 |
Last Update Date | 06/01/2021 |
Identifier | Type | State | Issuer |
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1285960732 | NPI | - | NPPES |
119040 | Other | OR | MAM CERTIFICATION |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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