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2929 Sw Multnomah Blvd Suite 303 Portland OR 97219-4025 | |
(877) 434-8021 | |
(503) 954-2041 |
Full Name | |
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Speciality | Clinic/center |
Location | 2929 Sw Multnomah Blvd, Portland, Oregon |
Authorized Official Name and Position | Carol Miller Baird (CEO) |
Authorized Official Contact | 8774348021 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2929 Sw Multnomah Blvd Suite 303 Portland OR 97219-4025 Ph: (877) 434-8021 | 2929 Sw Multnomah Blvd Suite 303 Portland OR 97219-4025 Ph: (877) 434-8021 |
NPI Number | 1780823112 |
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Provider Enumeration Date | 02/09/2009 |
Last Update Date | 02/09/2009 |
Identifier | Type | State | Issuer |
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1780823112 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | BB261109 (Oregon) | Primary |
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