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800 Se 181st Ave Portland OR 97233-4995 | |
(503) 489-9500 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 800 Se 181st Ave, Portland, Oregon |
Authorized Official Name and Position | Lauren Andrada (OFFICE MANAGER) |
Authorized Official Contact | 5036569030 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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800 Se 181st Ave Portland OR 97233-4995 Ph: (503) 489-9500 | 800 Se 181st Ave Portland OR 97233-4995 Ph: (503) 489-9500 |
NPI Number | 1174947196 |
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Provider Enumeration Date | 02/11/2014 |
Last Update Date | 08/01/2019 |
Identifier | Type | State | Issuer |
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1174947196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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