PROVIDENCE MEDICAL GROUP SOUTH – Nurse Practitioner, NPI 1790113405
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PROVIDENCE MEDICAL GROUP SOUTH
4400 NE HALSEY
BLDG 2 3RD FLR
PORTALND, OR 97213
Phone: (855) 229-6460
Fax: (503) 216-0710
Type: Location
PO BOX 3158
PORTLAND, OR 972083158
Phone:
Type: Mailing
18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR 972247259
Phone: (855) 229-6460
Fax: (503) 216-0710
Type: Location
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 97213)
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