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2501 Nw 229th Avenue Hillsboro OR 97124-5506 | |
(503) 893-9009 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 2501 Nw 229th Avenue, Hillsboro, Oregon |
Authorized Official Name and Position | Jonathan Liezman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Suite 120 Brentwood TN 37027 Ph: (615) 468-3188 | 2501 Nw 229th Avenue Hillsboro OR 97124-5506 Ph: (503) 893-9009 |
NPI Number | 1093098204 |
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Provider Enumeration Date | 09/23/2011 |
Last Update Date | 10/13/2022 |
Identifier | Type | State | Issuer |
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1093098204 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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