| Cognicare Northwest Llc | |
|
785 Nw 178th Ave Beaverton OR 97006-4047 | |
| (314) 983-9355 | |
| Not Available |
| Full Name | Cognicare Northwest Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 785 Nw 178th Ave, Beaverton, Oregon |
| Authorized Official Name and Position | Jason K Rhodes (OWNER) |
| Authorized Official Contact | 4246228428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognicare Northwest Llc 785 Nw 178th Ave Beaverton OR 97006-4047 Ph: () - | Cognicare Northwest Llc 785 Nw 178th Ave Beaverton OR 97006-4047 Ph: (314) 983-9355 |
| NPI Number | 1518798560 |
|---|---|
| Provider Enumeration Date | 08/12/2024 |
| Last Update Date | 10/28/2024 |
| Medicare PECOS PAC ID | 8022559558 |
|---|---|
| Medicare Enrollment ID | O20240924001452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518798560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michaela Roxana Westover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649987413 PECOS PAC ID: 7214393115 Enrollment ID: I20230518003411 |
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