| Prov Health Sys-or Shared-svs Div | |
|
9340 Sw Barnes Rd Suite 200 Portland OR 97225-6623 | |
| (503) 216-5641 | |
| (503) 216-2039 |
| Full Name | Prov Health Sys-or Shared-svs Div |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 9340 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Rebecca Marie Williams (FINANCE DIRECTOR - AMB SERVICES) |
| Authorized Official Contact | 5038936863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prov Health Sys-or Shared-svs Div 9340 Sw Barnes Rd Suite 200 Portland OR 97225-6623 Ph: (503) 216-5641 | Prov Health Sys-or Shared-svs Div 9340 Sw Barnes Rd Suite 200 Portland OR 97225-6623 Ph: (503) 216-5641 |
| NPI Number | 1184918955 |
|---|---|
| Provider Enumeration Date | 06/08/2011 |
| Last Update Date | 06/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184918955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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