| Concordia Wellness, Llc | |
|
3014 Ne Killingsworth St Portland OR 97211-6814 | |
| (503) 449-7631 | |
| Not Available |
| Full Name | Concordia Wellness, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 3014 Ne Killingsworth St, Portland, Oregon |
| Authorized Official Name and Position | Kim Magraw (SOLE MEMBER) |
| Authorized Official Contact | 5034497631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concordia Wellness, Llc 3014 Ne Killingsworth St Portland OR 97211-6814 Ph: (503) 449-7631 | Concordia Wellness, Llc 3014 Ne Killingsworth St Portland OR 97211-6814 Ph: (503) 449-7631 |
| NPI Number | 1023520814 |
|---|---|
| Provider Enumeration Date | 11/01/2017 |
| Last Update Date | 10/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023520814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4194 (California) | Secondary |
| 261Q00000X | Clinic/center | 19492 (Oregon) | Primary |
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