| Allergy Asthma Clinic Pc | |
|
14279 Glen Oak Rd Ste 204 Oregon City OR 97045-8008 | |
| (503) 631-4302 | |
| (503) 631-4035 |
| Full Name | Allergy Asthma Clinic Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 14279 Glen Oak Rd, Oregon City, Oregon |
| Authorized Official Name and Position | June M Hawkins (PRESIDENT/SECRETARY/TREASURER) |
| Authorized Official Contact | 5036314302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allergy Asthma Clinic Pc 20561 S Adams Vista Ct Oregon City OR 97045-7358 Ph: (503) 631-4302 | Allergy Asthma Clinic Pc 14279 Glen Oak Rd Ste 204 Oregon City OR 97045-8008 Ph: (503) 631-4302 |
| NPI Number | 1669429262 |
|---|---|
| Provider Enumeration Date | 05/28/2006 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669429262 | NPI | - | NPPES |
| 838724000 | Other | OR | BCBS GROUP |
| 009196 | Medicaid | OR | |
| MD12758 | Other | OR | MD LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD12758 (Oregon) | Primary |
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