| Oregon Adult Medicine Pc | |
|
2330 Nw Flanders St Ste 201 Portland OR 97210-3460 | |
| (503) 405-3042 | |
| (503) 717-9969 |
| Full Name | Oregon Adult Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2330 Nw Flanders St Ste 201, Portland, Oregon |
| Authorized Official Name and Position | Riyad Fares (OWNER) |
| Authorized Official Contact | 5034053042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon Adult Medicine Pc 2330 Nw Flanders St Ste 201 Portland OR 97210-3460 Ph: (714) 571-5000 | Oregon Adult Medicine Pc 2330 Nw Flanders St Ste 201 Portland OR 97210-3460 Ph: (503) 405-3042 |
| NPI Number | 1073167730 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 08/13/2020 |
| Medicare PECOS PAC ID | 9436480985 |
|---|---|
| Medicare Enrollment ID | O20191014002942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073167730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Krista A Swaninger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457571101 PECOS PAC ID: 8527158591 Enrollment ID: I20090415000683 |
| Provider Name | Riyad A Fares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841339108 PECOS PAC ID: 5395839211 Enrollment ID: I20090506000178 |
| Provider Name | Judith Robin Holeva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043324213 PECOS PAC ID: 3072513571 Enrollment ID: I20101108000130 |
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