| Pentimento, Inc. | |
|
522 Nw 12th Ave Portland OR 97209-3001 | |
| (503) 227-2886 | |
| (503) 790-1004 |
| Full Name | Pentimento, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 522 Nw 12th Ave, Portland, Oregon |
| Authorized Official Name and Position | Peter E. Leitner (PRESIDENT) |
| Authorized Official Contact | 5032272886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pentimento, Inc. 522 Nw 12th Ave. Portland OR 97209 Ph: (503) 227-2886 | Pentimento, Inc. 522 Nw 12th Ave Portland OR 97209-3001 Ph: (503) 227-2886 |
| NPI Number | 1710164181 |
|---|---|
| Provider Enumeration Date | 01/28/2008 |
| Last Update Date | 01/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710164181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2421 (Oregon) | Primary |
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