| South Tabor Family Physicians | |
|
10803 Se Cherry Blossom Dr Portland OR 97216-3107 | |
| (503) 261-7200 | |
| (503) 261-7249 |
| Full Name | South Tabor Family Physicians |
|---|---|
| Speciality | Clinic/Center |
| Location | 10803 Se Cherry Blossom Dr, Portland, Oregon |
| Authorized Official Name and Position | Londa Everett (ADMINISTRATOR) |
| Authorized Official Contact | 5032617200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Tabor Family Physicians 10803 Se Cherry Blossom Dr Portland OR 97216-3107 Ph: (503) 261-7200 | South Tabor Family Physicians 10803 Se Cherry Blossom Dr Portland OR 97216-3107 Ph: (503) 261-7200 |
| NPI Number | 1982649299 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 10/03/2012 |
| Medicare PECOS PAC ID | 8921093048 |
|---|---|
| Medicare Enrollment ID | O20040419000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982649299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 262417 (Oregon) | Primary |
| Provider Name | Jeana M Crover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215963707 PECOS PAC ID: 9931120862 Enrollment ID: I20051207000703 |
| Provider Name | Shefaa George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508067075 PECOS PAC ID: 0840330817 Enrollment ID: I20091223000137 |
| Provider Name | Timothy P Janzen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003845447 PECOS PAC ID: 5597959692 Enrollment ID: I20101103000057 |
| Provider Name | Rhonda Lynn Durant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639105117 PECOS PAC ID: 3173710142 Enrollment ID: I20101203000597 |
| Provider Name | Sarah Marzolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700132909 PECOS PAC ID: 1052561859 Enrollment ID: I20121031000490 |
| Provider Name | Joshua M Reese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053630756 PECOS PAC ID: 8921248626 Enrollment ID: I20130913000444 |
| Provider Name | Stephanie Robin Casey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023399367 PECOS PAC ID: 2961657549 Enrollment ID: I20150817000072 |
| Provider Name | William B Bronec |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346530573 PECOS PAC ID: 6103048772 Enrollment ID: I20170111002198 |
| Provider Name | Kayce A Spear |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437513835 PECOS PAC ID: 5890088462 Enrollment ID: I20190910001142 |
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 | |
The Wellness Center Pdx Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1359 Ne 35th Avenue, Portland, OR 97232 Phone: 503-389-5545 | |
Providence Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5211 Ne Glisan St Bldg C, Portland, OR 97213 Phone: 503-215-6628 Fax: 503-215-6240 | |
Interstate Medical Office West Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3325 N Interstate Ave, Portland, OR 97227 Phone: 800-813-2000 Fax: 503-286-6879 | |
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 | |
Cascadia Behavioral Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7511 Se Henry St, Portland, OR 97206 Phone: 503-771-6061 Fax: 503-771-7514 |