| Premise Health Of Oregon Medical P C | |
|
6936 N Fathom St Portland OR 97217-3928 | |
| (971) 717-6307 | |
| (971) 717-6492 |
| Full Name | Premise Health Of Oregon Medical P C |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6936 N Fathom St, Portland, Oregon |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Oregon Medical P C 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Premise Health Of Oregon Medical P C 6936 N Fathom St Portland OR 97217-3928 Ph: (971) 717-6307 |
| NPI Number | 1134895410 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 10/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134895410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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