| Emerald Family Medicine Llc | |
|
819 Se Morrison St Ste 115 Portland OR 97214-6307 | |
| (503) 956-9396 | |
| (866) 883-0582 |
| Full Name | Emerald Family Medicine Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 819 Se Morrison St, Portland, Oregon |
| Authorized Official Name and Position | Emerald Mansfield (OWNER) |
| Authorized Official Contact | 5035679355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Family Medicine Llc 5719 Se 72nd Ave Portland OR 97206-5811 Ph: (503) 567-9355 | Emerald Family Medicine Llc 819 Se Morrison St Ste 115 Portland OR 97214-6307 Ph: (503) 956-9396 |
| NPI Number | 1245633049 |
|---|---|
| Provider Enumeration Date | 10/07/2014 |
| Last Update Date | 10/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245633049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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