| Surelux, Llc | |
|
2100 Ne Broadway St Suite 225 Portland OR 97232-1569 | |
| (503) 719-5000 | |
| (971) 255-1754 |
| Full Name | Surelux, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 Ne Broadway St, Portland, Oregon |
| Authorized Official Name and Position | Christina Yogerst (SOLE MBR) |
| Authorized Official Contact | 5037195000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surelux, Llc 2100 Ne Broadway St Suite 225 Portland OR 97232-1569 Ph: (503) 719-5000 | Surelux, Llc 2100 Ne Broadway St Suite 225 Portland OR 97232-1569 Ph: (503) 719-5000 |
| NPI Number | 1669928578 |
|---|---|
| Provider Enumeration Date | 08/31/2016 |
| Last Update Date | 10/20/2016 |
| Medicare PECOS PAC ID | 7113215948 |
|---|---|
| Medicare Enrollment ID | O20161011003062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669928578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Christina N Yogerst |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1619051513 PECOS PAC ID: 3375618671 Enrollment ID: I20091029000389 |
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