| Providence Elder Place Portland | |
|
4540 Ne Glisan St Portland OR 97213-2333 | |
| (503) 215-3738 | |
| (503) 215-6942 |
| Full Name | Providence Elder Place Portland |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4540 Ne Glisan St, Portland, Oregon |
| Authorized Official Name and Position | Donald M Keister (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5032153612 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Elder Place Portland 13007 Ne Glisan St Portland OR 97230-2545 Ph: (503) 215-6556 | Providence Elder Place Portland 4540 Ne Glisan St Portland OR 97213-2333 Ph: (503) 215-3738 |
| NPI Number | 1023098118 |
|---|---|
| Provider Enumeration Date | 01/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023098118 | NPI | - | NPPES |
| 005673 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (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 |