| Pacific Healthcare Providers, Llc | |
|
14355 Sw Allen Blvd Ste 130 Beaverton OR 97005-4700 | |
| (503) 956-9432 | |
| Not Available |
| Full Name | Pacific Healthcare Providers, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 14355 Sw Allen Blvd Ste 130, Beaverton, Oregon |
| Authorized Official Name and Position | Leane Beth Wadsworth (INSURANCE COORDINATOR) |
| Authorized Official Contact | 5033122279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Healthcare Providers, Llc 6107 Sw Murray Blvd Ste 516 Beaverton OR 97008-4421 Ph: (503) 956-9432 | Pacific Healthcare Providers, Llc 14355 Sw Allen Blvd Ste 130 Beaverton OR 97005-4700 Ph: (503) 956-9432 |
| NPI Number | 1720722051 |
|---|---|
| Provider Enumeration Date | 04/22/2022 |
| Last Update Date | 04/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720722051 | NPI | - | NPPES |
| 1639113590 | Other | OR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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