The Medical Wellness Clinic, Llc

NPI 1295922755 - Internal Medicine - 207R00000X

NPI Details
NPI 1295922755
Enumeration Date 09/28/2007
Last Updated 09/28/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name STEPHEN A STEPHEN
Position CLINIC DIRECTOR
Phone (503) 697-3001
Fax (503) 697-0906
Practice Location
4035 MERCANTILE DR
SUITE 101
LAKE OSWEGO OR, 97035-2546, US
Phone (503) 697-3001
Fax (503) 697-0906
Business Location
4035 MERCANTILE DR
SUITE 101
LAKE OSWEGO OR, 97035-2546, US
Phone (503) 697-3001
Fax (503) 697-0906
Toxanomy
Taxonomy Code 207R00000X
License State Oregon
License Number MD07794
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According to our database, The Medical Wellness Clinic, Llc NPI is 1295922755, taxonomy code is 207R00000X and license number is MD07794, license state is located at Oregon. The Medical Wellness Clinic, Llc physically located at 4035 Mercantile Dr, Lake Oswego OR, 97035-2546. NPI Number 1033115704 has the healthcare provider type.

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1295922755 NPI number is provided on an as is basis without warranty of any kind. 1295922755 is maintained by the National Plan & Provider Enumeration System. The contents of The Medical Wellness Clinic, Llc are for informational purposes only.