| Moore Care Providers | |
|
1675 Sw Marlow Ave Portland OR 97225-5104 | |
| (503) 442-6546 | |
| Not Available |
| Full Name | Moore Care Providers |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1675 Sw Marlow Ave, Portland, Oregon |
| Authorized Official Name and Position | Kent G Benner (CEO) |
| Authorized Official Contact | 5034426546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Care Providers 1675 Sw Marlow Ave Portland OR 97225-5104 Ph: () - | Moore Care Providers 1675 Sw Marlow Ave Portland OR 97225-5104 Ph: (503) 442-6546 |
| NPI Number | 1811215403 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 05/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811215403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MD12769 (Oregon) | Primary |
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