| Nancy K Dougherty Mdpc | |
|
10101 Se Main St Ste 1004 Portland OR 97216 | |
| (503) 255-0109 | |
| (503) 255-0540 |
| Full Name | Nancy K Dougherty Mdpc |
|---|---|
| Speciality | Family Medicine |
| Location | 10101 Se Main St, Portland, Oregon |
| Authorized Official Name and Position | Nancy Kathleen Dougherty (CEO PRESIDENT) |
| Authorized Official Contact | 5032550109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy K Dougherty Mdpc 10101 Se Main St Ste 1004 Portland OR 97216 Ph: (503) 255-0109 | Nancy K Dougherty Mdpc 10101 Se Main St Ste 1004 Portland OR 97216 Ph: (503) 255-0109 |
| NPI Number | 1124213038 |
|---|---|
| Provider Enumeration Date | 09/13/2007 |
| Last Update Date | 10/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124213038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD17570 (Oregon) | Primary |
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