| Providence Integrative Medicine West | |
|
9135 Sw Barnes Rd Suite 161 Portland OR 97225-6601 | |
| (503) 216-0246 | |
| Not Available |
| Full Name | Providence Integrative Medicine West |
|---|---|
| Speciality | Clinic/center |
| Location | 9135 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Dennis Noonan (CHIEF FINANCE OFFICER) |
| Authorized Official Contact | 5032164657 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Integrative Medicine West Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Integrative Medicine West 9135 Sw Barnes Rd Suite 161 Portland OR 97225-6601 Ph: (503) 216-0246 |
| NPI Number | 1033345012 |
|---|---|
| Provider Enumeration Date | 06/04/2009 |
| Last Update Date | 06/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033345012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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