| |
333 Se 7th Ave Sutie 5500 Hillsboro OR 97123-4157 | |
(503) 597-4500 | |
(503) 597-4501 |
Full Name | |
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Speciality | Clinic/Center |
Location | 333 Se 7th Ave, Hillsboro, Oregon |
Authorized Official Name and Position | Annmarie Dennis (CORPORATE COMPLIANCE OFFICER) |
Authorized Official Contact | 5032141652 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 6149 Aloha OR 97007-0149 Ph: (503) 597-4500 | 333 Se 7th Ave Sutie 5500 Hillsboro OR 97123-4157 Ph: (503) 597-4500 |
NPI Number | 1053859694 |
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Provider Enumeration Date | 02/02/2017 |
Last Update Date | 08/19/2023 |
Medicare PECOS PAC ID | 7113823881 |
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Medicare Enrollment ID | O20170925001367 |
Identifier | Type | State | Issuer |
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1053859694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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