| Pmg Bridgeport Immediate Care | |
|
18040 Sw Lower Boones Ferry Rd Suite 100 Tigard OR 97224 | |
| (503) 216-0700 | |
| Not Available |
| Full Name | Pmg Bridgeport Immediate Care |
|---|---|
| Speciality | Clinic/center |
| Location | 18040 Sw Lower Boones Ferry Rd, Tigard, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST CORP SECRETARY FOR ENROLLMENTS) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg Bridgeport Immediate Care Po Box 3158 Portland OR 97208-3158 Ph: () - | Pmg Bridgeport Immediate Care 18040 Sw Lower Boones Ferry Rd Suite 100 Tigard OR 97224 Ph: (503) 216-0700 |
| NPI Number | 1821224957 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 07/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821224957 | NPI | - | NPPES |
| 500611230 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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