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1321 Ne 99th Ave Suite 200 Portland OR 97220-9439 | |
(503) 215-4250 | |
(503) 215-4255 |
Full Name | |
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Speciality | Family Medicine |
Location | 1321 Ne 99th Ave, Portland, Oregon |
Authorized Official Name and Position | Donald W Anderson (ASST SEC ENROLLMENT/EVPREIMB) |
Authorized Official Contact | 4255255392 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6446 | 1321 Ne 99th Ave Suite 200 Portland OR 97220-9439 Ph: (503) 215-4250 |
NPI Number | 1124129903 |
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Provider Enumeration Date | 09/26/2006 |
Last Update Date | 06/10/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124129903 | NPI | - | NPPES |
022844 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Woodstock Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Se Woodstock Blvd, Portland, OR 97206 Phone: 503-236-1830 Fax: 503-236-1908 | |
Internal Medicine Consultants, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9585 Sw Washington Square Rd, Portland, OR 97223 Phone: 503-320-2121 Fax: 503-641-4158 | |
Jenna Halbert, Nd Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Ne Russell St Ste 207, Portland, OR 97212 Phone: 503-482-8301 | |