| Legacy Medical Group Firwood | |
|
36860 Industrial Way Sandy OR 97055-7371 | |
| (503) 826-0206 | |
| Not Available |
| Full Name | Legacy Medical Group Firwood |
|---|---|
| Speciality | Clinic/Center |
| Location | 36860 Industrial Way, Sandy, Oregon |
| Authorized Official Name and Position | Linda S Hoff (SENIOR VP AND CFO) |
| Authorized Official Contact | 5034155730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Medical Group Firwood Po Box 3777 Portland OR 97208-3777 Ph: (503) 413-3958 | Legacy Medical Group Firwood 36860 Industrial Way Sandy OR 97055-7371 Ph: (503) 826-0206 |
| NPI Number | 1730472192 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 02/10/2017 |
| Medicare PECOS PAC ID | 0244144004 |
|---|---|
| Medicare Enrollment ID | O20110630000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730472192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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