| Providence Portland Medical Center | |
|
6241 Se Alder St Portland OR 97215-1971 | |
| (503) 334-7678 | |
| Not Available |
| Full Name | Providence Portland Medical Center |
|---|---|
| Speciality | Clinic/center |
| Location | 6241 Se Alder St, Portland, Oregon |
| Authorized Official Name and Position | Adam Blomberg (RESIDENT PHYSICIAN) |
| Authorized Official Contact | 5033347678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Portland Medical Center 6241 Se Alder St Portland OR 97215-1971 Ph: () - | Providence Portland Medical Center 6241 Se Alder St Portland OR 97215-1971 Ph: (503) 334-7678 |
| NPI Number | 1427258490 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 12/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427258490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD27617 (Oregon) | Primary |
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