| Providence Cancer Survivor Clinic - East | |
|
4805 Ne Glisan St Suite 6n50 Portland OR 97213-2933 | |
| (503) 215-7901 | |
| (503) 215-7904 |
| Full Name | Providence Cancer Survivor Clinic - East |
|---|---|
| Speciality | Clinic/center |
| Location | 4805 Ne Glisan St, Portland, Oregon |
| Authorized Official Name and Position | Keenan B Freeman (CFO) |
| Authorized Official Contact | 5038936524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Cancer Survivor Clinic - East Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6494 | Providence Cancer Survivor Clinic - East 4805 Ne Glisan St Suite 6n50 Portland OR 97213-2933 Ph: (503) 215-7901 |
| NPI Number | 1710292404 |
|---|---|
| Provider Enumeration Date | 08/18/2010 |
| Last Update Date | 07/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710292404 | NPI | - | NPPES |
| 500639496 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Woodstock Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Se Woodstock Blvd, Portland, OR 97206 Phone: 503-236-1830 Fax: 503-236-1908 | |
Internal Medicine Consultants, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9585 Sw Washington Square Rd, Portland, OR 97223 Phone: 503-320-2121 Fax: 503-641-4158 | |
The Wellness Center Pdx Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1359 Ne 35th Avenue, Portland, OR 97232 Phone: 503-389-5545 | |
Providence Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5211 Ne Glisan St Bldg C, Portland, OR 97213 Phone: 503-215-6628 Fax: 503-215-6240 | |
Interstate Medical Office West Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3325 N Interstate Ave, Portland, OR 97227 Phone: 800-813-2000 Fax: 503-286-6879 | |
Jenna Halbert, Nd Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Ne Russell St Ste 207, Portland, OR 97212 Phone: 503-482-8301 | |
Cascadia Behavioral Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7511 Se Henry St, Portland, OR 97206 Phone: 503-771-6061 Fax: 503-771-7514 |