| Providence Medical Group Anticoagulation Telephone Management | |
|
3300 Se Dwyer Dr Suite 304 Milwaukie OR 97222-6548 | |
| (503) 513-8043 | |
| Not Available |
| Full Name | Providence Medical Group Anticoagulation Telephone Management |
|---|---|
| Speciality | Clinic/center |
| Location | 3300 Se Dwyer Dr, Milwaukie, Oregon |
| Authorized Official Name and Position | Keenan B Freeman (CFO) |
| Authorized Official Contact | 5038936524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Anticoagulation Telephone Management Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group Anticoagulation Telephone Management 3300 Se Dwyer Dr Suite 304 Milwaukie OR 97222-6548 Ph: (503) 513-8043 |
| NPI Number | 1053727636 |
|---|---|
| Provider Enumeration Date | 07/03/2014 |
| Last Update Date | 07/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053727636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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