| Roberts Street Clinic, P.c. | |
|
400 Ne Roberts Ave Gresham OR 97030-7464 | |
| (503) 669-3066 | |
| (503) 665-6404 |
| Full Name | Roberts Street Clinic, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 400 Ne Roberts Ave, Gresham, Oregon |
| Authorized Official Name and Position | Linda Mankey (CLINIC MANAGER) |
| Authorized Official Contact | 5036693066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roberts Street Clinic, P.c. 400 Ne Roberts Ave Gresham OR 97030-7464 Ph: (503) 669-3066 | Roberts Street Clinic, P.c. 400 Ne Roberts Ave Gresham OR 97030-7464 Ph: (503) 669-3066 |
| NPI Number | 1003024423 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 10/10/2007 |
| Medicare PECOS PAC ID | 5991787426 |
|---|---|
| Medicare Enrollment ID | O20040607000983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003024423 | NPI | - | NPPES |
| 205823 | Medicaid | OR | |
| 287658 | Medicaid | OR | |
| 029582 | Medicaid | OR | |
| 079546 | Medicaid | OR | |
| 287698 | Medicaid | OR |
| Provider Name | Toni L Hero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851387849 PECOS PAC ID: 6901889443 Enrollment ID: I20040608000180 |
| Provider Name | Steven D Maness |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700872785 PECOS PAC ID: 5890846315 Enrollment ID: I20101123001143 |
| Provider Name | Matthew C Upshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407842487 PECOS PAC ID: 6709937220 Enrollment ID: I20110106000625 |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Nw Division St, Gresham, OR 97030 Phone: 503-215-9500 Fax: 503-215-9525 | |
Gresham Women's Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Ne Roberts Ave, Gresham, OR 97030 Phone: 503-477-2478 | |
Gresham Internal Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24900 Se Stark St Ste 109, Gresham, OR 97030 Phone: 503-667-1015 Fax: 503-667-0406 | |
Mobile Vaccs Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3838 Se Saint Andrews Pl, Gresham, OR 97080 Phone: 503-858-7403 | |
Gresham Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Ne 7th St, Gresham, OR 97030 Phone: 503-238-0769 Fax: 503-889-2599 | |
Legacy Mount Hood Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 24800 Se Stark St, Gresham, OR 97030 Phone: 503-674-1122 |