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1568795946
STARK MEDICAL DIAGNOSTIC CENTER, INC
PORTLAND, OR
NPI
1568795946
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Entity Type
Organization
Authorized Contact
JORGE MACIAS
Secretary
503-408-7578
Organization Subpart ?
No
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2009-09-16
Last Update Date
2009-09-16
Business Address
STARK MEDICAL DIAGNOSTIC CENTER, INC
13232 SE STARK ST
PORTLAND, OR 97233-1573
Phone number: 503-408-7578
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Mailing Address
STARK MEDICAL DIAGNOSTIC CENTER, INC
13232 SE STARK ST
PORTLAND, OR 97233-1573
Phone number: 503-408-7578
Copy
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