| Rosewood Family Health At Gateway | |
|
135 Ne 102nd Ave Portland OR 97220-4167 | |
| (509) 865-6175 | |
| (509) 865-2139 |
| Full Name | Rosewood Family Health At Gateway |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 135 Ne 102nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Shannon Fernandez (BILLING VP) |
| Authorized Official Contact | 5088656175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosewood Family Health At Gateway Po Box 190 Toppenish WA 98948-0190 Ph: (509) 865-6175 | Rosewood Family Health At Gateway 135 Ne 102nd Ave Portland OR 97220-4167 Ph: (509) 865-6175 |
| NPI Number | 1184246134 |
|---|---|
| Provider Enumeration Date | 05/13/2020 |
| Last Update Date | 11/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184246134 | NPI | - | NPPES |
| 167254698 | Other | OR | REGISTRY NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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