FANNO CREEK CLINIC LLC

PORTLAND, OR
NPI1609876705
Entity TypeOrganization
Authorized ContactLARRY M REED
Clinic Manager
503-452-0915
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: OR  2802)
Enumeration Date2005-07-29
Last Update Date2007-10-16
Business Address
FANNO CREEK CLINIC LLC
2400 SW VERMONT ST
PORTLAND, OR 97219-1940
Phone number: 503-452-0915
Mailing Address
FANNO CREEK CLINIC LLC
2400 SW VERMONT ST
PORTLAND, OR 97219-1940
Phone number: 503-452-0915
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