| The Endocrine Clinic Pc | |
|
10000 Se Main St Suite 403 Portland OR 97216-2448 | |
| (503) 256-4096 | |
| (503) 256-0101 |
| Full Name | The Endocrine Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10000 Se Main St, Portland, Oregon |
| Authorized Official Name and Position | Tami L Prideaux (CLINIC MANAGER) |
| Authorized Official Contact | 5032564096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Endocrine Clinic Pc 10000 Se Main St Suite 403 Portland OR 97216-2448 Ph: (503) 256-4096 | The Endocrine Clinic Pc 10000 Se Main St Suite 403 Portland OR 97216-2448 Ph: (503) 256-4096 |
| NPI Number | 1255367884 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1850363003 |
|---|---|
| Medicare Enrollment ID | O20040809001305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255367884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD019378 (Oregon) | Primary |
| Provider Name | Diana C Negreanu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538282447 PECOS PAC ID: 3678660230 Enrollment ID: I20071029000442 |
| Provider Name | Diane M Karl |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891797346 PECOS PAC ID: 6800983453 Enrollment ID: I20101104000573 |
| Provider Name | Gerald D Youker |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1912908138 PECOS PAC ID: 8729176110 Enrollment ID: I20101104001519 |
| Provider Name | Olesya Petrenko |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427585942 PECOS PAC ID: 5597094532 Enrollment ID: I20230720003819 |
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