| Providence Medical Group Oregon City General Surgery At Sunnyside | |
|
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6802 | |
| (503) 823-6525 | |
| Not Available |
| Full Name | Providence Medical Group Oregon City General Surgery At Sunnyside |
|---|---|
| Speciality | Clinic/center |
| Location | 9290 Se Sunnybrook Blvd, Clackamas, 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 Oregon City General Surgery At Sunnyside Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group Oregon City General Surgery At Sunnyside 9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6802 Ph: (503) 823-6525 |
| NPI Number | 1609298967 |
|---|---|
| Provider Enumeration Date | 01/06/2014 |
| Last Update Date | 12/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609298967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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