| Golden Dawn Clinic | |
|
2448 Se 89th Ave Suite 1 Portland OR 97216-2052 | |
| (503) 788-6483 | |
| (503) 772-7914 |
| Full Name | Golden Dawn Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2448 Se 89th Ave, Portland, Oregon |
| Authorized Official Name and Position | Thuyet Van Tran (OWNER) |
| Authorized Official Contact | 6167804981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Dawn Clinic 21711 Se Highway 212 Damascus OR 97089-9250 Ph: () - | Golden Dawn Clinic 2448 Se 89th Ave Suite 1 Portland OR 97216-2052 Ph: (503) 788-6483 |
| NPI Number | 1841546843 |
|---|---|
| Provider Enumeration Date | 07/27/2012 |
| Last Update Date | 07/27/2012 |
| Medicare PECOS PAC ID | 4981851870 |
|---|---|
| Medicare Enrollment ID | O20120828000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841546843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD154469 (Oregon) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | MD154469 (Oregon) | Secondary |
| Provider Name | Thuyet V Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063626497 PECOS PAC ID: 7012188220 Enrollment ID: I20110920000515 |
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