GRESHAM INTERNAL MEDICINE CLINIC
Organization (NPI-2)
Active
Internal Medicine
Provider Information
- NPI Number
1134204340- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 24900 SE STARK ST STE 109, GRESHAM, OR, 970303381
- Phone
- (503) 667-1015
- Fax
- (503) 667-0406
Specialties & Taxonomies
Internal Medicine
Primary License: OR #01794