| Providence Health Express Hv | |
|
16180 Se Sunnyside Rd Suite 203 Happy Valley OR 97015-6302 | |
| (855) 229-6460 | |
| (503) 216-0710 |
| Full Name | Providence Health Express Hv |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 16180 Se Sunnyside Rd, Happy Valley, Oregon |
| Authorized Official Name and Position | Keenan B Freeman (CFO) |
| Authorized Official Contact | 5035936524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health Express Hv Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Health Express Hv 16180 Se Sunnyside Rd Suite 203 Happy Valley OR 97015-6302 Ph: (855) 229-6460 |
| NPI Number | 1609204312 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609204312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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