INTEGRATED MEDICINE GROUP LLC NPI 1033249404

NPI Information

INTEGRATED MEDICINE GROUP LLC is a general practice in Portland, OR. INTEGRATED MEDICINE GROUP LLC NPI is 1033249404. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

163 NE 102ND AVE
BUILDING V
PORTLAND, OR
ZIP 97220-169
Phone: (503) 257-3327
Fax: (503) 257-3374

The provider's authorized official is Christy C Heitsch .
The authorized official title is Owner Administrative Director and has the following contact phone number (503) 257-3327.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 2/21/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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