Unknown Individual – Specialist, NPI 1184607244
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
9735, Southwest Shady Lane, Greenburg Road, Tigard, Metro, Washington County, Oregon, 97223, United States
#102
TIGARD, OR 972235481
Phone: (503) 620-5614
Fax: (503) 598-4688
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97223)
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