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5517 N Commercial Ave Portland OR 97217-2339 | |
(503) 223-0900 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 5517 N Commercial Ave, Portland, Oregon |
Authorized Official Name and Position | Bonny Seal (OWNER) |
Authorized Official Contact | 5032230900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5517 N Commercial Ave Portland OR 97217-2339 Ph: () - | 5517 N Commercial Ave Portland OR 97217-2339 Ph: (503) 223-0900 |
NPI Number | 1578806915 |
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Provider Enumeration Date | 04/04/2013 |
Last Update Date | 04/04/2013 |
Identifier | Type | State | Issuer |
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1578806915 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 1727 (Oregon) | Primary |
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