Providence Hospitalists East | |
4805 Ne Glisan St Suite Bg05 Portland OR 97213-2933 | |
(503) 215-2392 | |
Not Available |
Full Name | Providence Hospitalists East |
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Speciality | Clinic/center |
Location | 4805 Ne Glisan St, Portland, Oregon |
Authorized Official Name and Position | William Olson (CHIEF FINANCE OFFICER) |
Authorized Official Contact | 5032156241 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Providence Hospitalists East Po Box 3178 Portland OR 97208-3178 Ph: () - | Providence Hospitalists East 4805 Ne Glisan St Suite Bg05 Portland OR 97213-2933 Ph: (503) 215-2392 |
NPI Number | 1134240021 |
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Provider Enumeration Date | 04/02/2007 |
Last Update Date | 10/30/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134240021 | NPI | - | NPPES |
286612 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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