| Bridgeport Family Medicine Llc | |
|
16083 Sw Upper Boones Ferry Rd Ste 320 Tigard OR 97224-7736 | |
| (503) 603-9087 | |
| (503) 603-9122 |
| Full Name | Bridgeport Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 16083 Sw Upper Boones Ferry Rd, Tigard, Oregon |
| Authorized Official Name and Position | Standley Adamek (C0-OWNER) |
| Authorized Official Contact | 5036039087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Family Medicine Llc 16083 Sw Upper Boones Ferry Rd Ste 320 Tigard OR 97224-7736 Ph: (503) 603-9087 | Bridgeport Family Medicine Llc 16083 Sw Upper Boones Ferry Rd Ste 320 Tigard OR 97224-7736 Ph: (503) 603-9087 |
| NPI Number | 1205236445 |
|---|---|
| Provider Enumeration Date | 08/25/2014 |
| Last Update Date | 08/25/2014 |
| Medicare PECOS PAC ID | 1254671282 |
|---|---|
| Medicare Enrollment ID | O20190328002437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205236445 | NPI | - | NPPES |
| 1144515230 | Other | OR | NPI |
| 1699060780 | Other | OR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO163558 (Oregon) | Primary |
| Provider Name | Lindsay K Kleps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750471025 PECOS PAC ID: 0941247647 Enrollment ID: I20050414000186 |
| Provider Name | Andrea Tremaine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952735086 PECOS PAC ID: 7416177951 Enrollment ID: I20161116002924 |
| Provider Name | Standley C Adamek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144515230 PECOS PAC ID: 9234432360 Enrollment ID: I20190823002550 |
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