| Providence Medical Group Newberg Specialties At Tanasbourne | |
|
18650 Nw Cornell Rd Suite 212 Hillsboro OR 97124-9208 | |
| (503) 537-5900 | |
| (503) 537-5959 |
| Full Name | Providence Medical Group Newberg Specialties At Tanasbourne |
|---|---|
| Speciality | Clinic/center |
| Location | 18650 Nw Cornell Rd, Hillsboro, 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 Newberg Specialties At Tanasbourne Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group Newberg Specialties At Tanasbourne 18650 Nw Cornell Rd Suite 212 Hillsboro OR 97124-9208 Ph: (503) 537-5900 |
| NPI Number | 1003223959 |
|---|---|
| Provider Enumeration Date | 07/11/2014 |
| Last Update Date | 10/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003223959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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Tuality Obstetrics & Gynecology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 364 Se 8th Ave Ste 205, Hillsboro, OR 97123 Phone: 503-681-4145 Fax: 503-681-4146 | |
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