| Jeremy Mikolai Nd Inc | |
|
2540 Ne M L King Blvd Portland OR 97212-3732 | |
| (507) 800-0056 | |
| (844) 965-9136 |
| Full Name | Jeremy Mikolai Nd Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2540 Ne M L King Blvd, Portland, Oregon |
| Authorized Official Name and Position | Jeremy Michael Mikolai (MEDICAL DIRECTOR/CEO) |
| Authorized Official Contact | 5073274451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Mikolai Nd Inc 4110 Se Hawthorne Blvd # 132 Portland OR 97214-5246 Ph: (507) 800-0056 | Jeremy Mikolai Nd Inc 2540 Ne M L King Blvd Portland OR 97212-3732 Ph: (507) 800-0056 |
| NPI Number | 1033674841 |
|---|---|
| Provider Enumeration Date | 02/06/2019 |
| Last Update Date | 02/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033674841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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