| Deep Creek Family Medicine | |
|
39084 Proctor Blvd Ste A Sandy OR 97055-8064 | |
| (971) 313-2317 | |
| Not Available |
| Full Name | Deep Creek Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 39084 Proctor Blvd Ste A, Sandy, Oregon |
| Authorized Official Name and Position | Joshua J. Reese (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9713132317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Creek Family Medicine 39084 Proctor Blvd Ste A Sandy OR 97055-8064 Ph: (971) 313-2317 | Deep Creek Family Medicine 39084 Proctor Blvd Ste A Sandy OR 97055-8064 Ph: (971) 313-2317 |
| NPI Number | 1255949434 |
|---|---|
| Provider Enumeration Date | 07/14/2020 |
| Last Update Date | 09/08/2020 |
| Medicare PECOS PAC ID | 9739507450 |
|---|---|
| Medicare Enrollment ID | O20200912000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255949434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Joshua M Reese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053630756 PECOS PAC ID: 8921248626 Enrollment ID: I20130913000444 |
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