| Hosseinion Family Medicine | |
|
3942 Se Hawthorne Blvd Portland OR 97214-5242 | |
| (503) 234-2070 | |
| (503) 235-3956 |
| Full Name | Hosseinion Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3942 Se Hawthorne Blvd, Portland, Oregon |
| Authorized Official Name and Position | Shahram Hosseinion (PROVIDER/OWNER) |
| Authorized Official Contact | 5032342070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hosseinion Family Medicine Po Box 97115 Lakewood WA 98497-0115 Ph: (253) 588-7911 | Hosseinion Family Medicine 3942 Se Hawthorne Blvd Portland OR 97214-5242 Ph: (503) 234-2070 |
| NPI Number | 1295044485 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 11/10/2015 |
| Medicare PECOS PAC ID | 4385826866 |
|---|---|
| Medicare Enrollment ID | O20110303000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295044485 | NPI | - | NPPES |
| MD26562 | Other | OR | MEDICAL PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD26562 (Oregon) | Primary |
| Provider Name | Shahram Hosseinion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164477147 PECOS PAC ID: 1850390436 Enrollment ID: I20061208000146 |
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