| Ppm Oregon Llc | |
|
7515 Ne Ambassador Pl Ste C Portland OR 97220-1379 | |
| (888) 253-6598 | |
| Not Available |
| Full Name | Ppm Oregon Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7515 Ne Ambassador Pl Ste C, Portland, Oregon |
| Authorized Official Name and Position | Amber L Tueller (SECRETARY) |
| Authorized Official Contact | 2082072726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm Oregon Llc 1675 E Riverside Dr Ste 200 Eagle ID 83616-7473 Ph: () - | Ppm Oregon Llc 7515 Ne Ambassador Pl Ste C Portland OR 97220-1379 Ph: (888) 253-6598 |
| NPI Number | 1891434528 |
|---|---|
| Provider Enumeration Date | 06/01/2022 |
| Last Update Date | 06/06/2025 |
| Medicare PECOS PAC ID | 3476939265 |
|---|---|
| Medicare Enrollment ID | O20220930002918 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891434528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Viktoriya Dimaku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619404316 PECOS PAC ID: 6002189347 Enrollment ID: I20170907002231 |
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