| University Professional Service Plc-013 | |
|
1501 Ne Medical Center Dr Bend OR 97701-6051 | |
| (503) 494-4072 | |
| Not Available |
| Full Name | University Professional Service Plc-013 |
|---|---|
| Speciality | General Practice |
| Location | 1501 Ne Medical Center Dr, Bend, Oregon |
| Authorized Official Name and Position | Kelly Anne Smith (VP/ENTERPRISE REVENUE CYCLE) |
| Authorized Official Contact | 5034944422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Professional Service Plc-013 1400 Sw 5th Ave Fl 5 Portland OR 97201-5509 Ph: (866) 617-6855 | University Professional Service Plc-013 1501 Ne Medical Center Dr Bend OR 97701-6051 Ph: (503) 494-4072 |
| NPI Number | 1922255074 |
|---|---|
| Provider Enumeration Date | 08/20/2008 |
| Last Update Date | 09/12/2025 |
| Certification Date | 09/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922255074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
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