Evergreen Medical Solutions Llc | |
2250 Nw Flanders St Ste 109 Portland OR 97210-5409 | |
(503) 479-7713 | |
(503) 594-4039 |
Full Name | Evergreen Medical Solutions Llc |
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Speciality | General Practice |
Location | 2250 Nw Flanders St Ste 109, Portland, Oregon |
Authorized Official Name and Position | Andrew Miller (OWNER) |
Authorized Official Contact | 5034797713 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Evergreen Medical Solutions Llc 2250 Nw Flanders St Ste 109 Portland OR 97210-5409 Ph: (503) 479-7713 | Evergreen Medical Solutions Llc 2250 Nw Flanders St Ste 109 Portland OR 97210-5409 Ph: (503) 479-7713 |
NPI Number | 1558134338 |
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Provider Enumeration Date | 11/02/2023 |
Last Update Date | 01/15/2025 |
Medicare PECOS PAC ID | 6608227970 |
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Medicare Enrollment ID | O20240111000489 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558134338 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Andrew J Miller |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1861421117 PECOS PAC ID: 2961407978 Enrollment ID: I20060926000395 |
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