NPI:
1508040486
Provider Name:
PORTLAND CLINIC
Doing Business As: ROGER E. ALBERTY, M.D. SURGICAL CENTER
Classification:
Clinic/Center - 261QA1903X
Entity Type:
Organization
Specialization: Ambulatory Surgical
CLIA Number: 38D1080786
Address:
9100 SW OLESON ROAD
TIGARD, OR
ZIP 97223
Phone:
(503) 445-9066
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PORTLAND CLINIC is an ambulatory surgical clinic center in Tigard, OR. PORTLAND CLINIC NPI is 1508040486. The provider is registered as an organization entity type.
The provider Is Doing Business As Roger E. Alberty, M.d. Surgical Center.
The provider's business location address is:
9100 SW OLESON ROAD
TIGARD, OR
ZIP 97223
Phone: (503) 445-9066
The provider's authorized official is Dick Clark .
The authorized official title is Chief Executive Officer and has the following contact phone number (503) 221-0161.
The CLIA number assigned to this NPI record is 38D1080786 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/27/2007 and was last updated on 10/26/2020.