| Housecall Providers Inc | |
|
5100 Sw Macadam Ave Suite 200 Portland OR 97239-6102 | |
| (971) 202-5500 | |
| (971) 202-5555 |
| Full Name | Housecall Providers Inc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 5100 Sw Macadam Ave, Portland, Oregon |
| Authorized Official Name and Position | Benneth Ann Husted (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9702025500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Housecall Providers Inc 5100 Sw Macadam Ave Suite 200 Portland OR 97239-6102 Ph: (971) 202-5500 | Housecall Providers Inc 5100 Sw Macadam Ave Suite 200 Portland OR 97239-6102 Ph: (971) 202-5500 |
| NPI Number | 1619915774 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 01/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619915774 | NPI | - | NPPES |
| 150916 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 251G00000X | Hospice Care, Community Based | (Oregon) | Secondary |
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