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10250 Sw Greenburg Rd Suite 110 Building 4 Portland OR 97223-5443 | |
(503) 244-4268 | |
(503) 244-4261 |
Full Name | |
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Speciality | Family Medicine |
Location | 10250 Sw Greenburg Rd, Portland, Oregon |
Authorized Official Name and Position | Tanya E Carter (OWNER) |
Authorized Official Contact | 5032444268 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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10250 Sw Greenburg Rd Suite 110 Building 4 Portland OR 97223-5443 Ph: (503) 244-4268 | 10250 Sw Greenburg Rd Suite 110 Building 4 Portland OR 97223-5443 Ph: (503) 244-4268 |
NPI Number | 1093862245 |
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Provider Enumeration Date | 01/03/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1093862245 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | DO22368 (Oregon) | Primary |
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