| Columbia Clinic Pc | |
|
3202 Se 82nd Ave Portland OR 97266-2004 | |
| (503) 777-5995 | |
| (503) 777-8005 |
| Full Name | Columbia Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3202 Se 82nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Hoang Quang Nguyen (PRESIDENT) |
| Authorized Official Contact | 5037775995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Clinic Pc 3202 Se 82nd Ave Portland OR 97266-2004 Ph: (503) 777-5995 | Columbia Clinic Pc 3202 Se 82nd Ave Portland OR 97266-2004 Ph: (503) 777-5995 |
| NPI Number | 1184785842 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7012917842 |
|---|---|
| Medicare Enrollment ID | O20061230000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184785842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hoang Q Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013979533 PECOS PAC ID: 3779599808 Enrollment ID: I20060228000141 |
| Provider Name | Matthew W Shook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841487311 PECOS PAC ID: 7810069598 Enrollment ID: I20130102000235 |
| Provider Name | Triet A Nguyen |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1518587575 PECOS PAC ID: 1557784857 Enrollment ID: I20230725003916 |
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