| Rosewood Family Health At Lents | |
|
9047 Se Foster Rd Portland OR 97266 | |
| (509) 865-6175 | |
| (509) 865-2139 |
| Full Name | Rosewood Family Health At Lents |
|---|---|
| Speciality | Clinic/Center |
| Location | 9047 Se Foster Rd, Portland, Oregon |
| Authorized Official Name and Position | Shannon Fernandez (BILLING VP) |
| Authorized Official Contact | 5088656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosewood Family Health At Lents Po Box 190 Toppenish WA 98948-0190 Ph: (509) 865-6175 | Rosewood Family Health At Lents 9047 Se Foster Rd Portland OR 97266 Ph: (509) 865-6175 |
| NPI Number | 1205325727 |
|---|---|
| Provider Enumeration Date | 05/10/2018 |
| Last Update Date | 11/01/2022 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20201006002631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205325727 | NPI | - | NPPES |
| 022793 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 143104099 (Oregon) | Primary |
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