Old Town Clinic Ad

NPI 1265833040 - Clinic/Center - 261QF0400X

NPI Details
NPI 1265833040
Enumeration Date 09/11/2014
Last Updated 09/11/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name ED ED
Position EXECUTIVE DIRECTOR
Phone (503) 228-4533
Fax
Practice Location
727 W BURNSIDE ST
PORTLAND OR, 97209-3514, US
Phone (503) 228-4533
Fax
Business Location
232 NW 6TH AVE
PORTLAND OR, 97209-3609, US
Phone
Fax
Toxanomy
Taxonomy Code 261QF0400X
License State
License Number
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According to our database, Old Town Clinic Ad NPI is 1265833040, taxonomy code is 261QF0400X Old Town Clinic Ad physically located at 727 W Burnside St, Portland OR, 97209-3514. NPI Number 1033115704 has the healthcare provider type.

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1265833040 NPI number is provided on an as is basis without warranty of any kind. 1265833040 is maintained by the National Plan & Provider Enumeration System. The contents of Old Town Clinic Ad are for informational purposes only.