| Providence Hospitalists Southeast | |
|
10150 Se 32nd Ave Milwaukie OR 97222-6516 | |
| (503) 513-8336 | |
| Not Available |
| Full Name | Providence Hospitalists Southeast |
|---|---|
| Speciality | Clinic/center |
| Location | 10150 Se 32nd Ave, Milwaukie, Oregon |
| Authorized Official Name and Position | Eric Olson (CHIEF FINANCE OFFICER) |
| Authorized Official Contact | 5035138308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Hospitalists Southeast Po Box 3349 Portland OR 97208-3349 Ph: () - | Providence Hospitalists Southeast 10150 Se 32nd Ave Milwaukie OR 97222-6516 Ph: (503) 513-8336 |
| NPI Number | 1689795478 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 10/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689795478 | NPI | - | NPPES |
| 023300 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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