LAKE GROVE FAMILY MEDICAL CLINIC LLC NPI 1366982258

NPI Information

NPI: 1366982258
Provider Name: LAKE GROVE FAMILY MEDICAL CLINIC LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
16463 BOONES FERRY RD
SUITE 100
LAKE OSWEGO, OR
ZIP 97035
Phone: (503) 635-1350
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LAKE GROVE FAMILY MEDICAL CLINIC LLC is a primary care clinic center in Lake Oswego, OR. LAKE GROVE FAMILY MEDICAL CLINIC LLC NPI is 1366982258. The provider is registered as an organization entity type.

The provider's business location address is:

16463 BOONES FERRY RD
SUITE 100
LAKE OSWEGO, OR
ZIP 97035-259
Phone: (503) 635-1350
Fax: (503) 635-8470

The provider's authorized official is Shannon K Sabins .
The authorized official title is Assistant Clinic Manager and has the following contact phone number (503) 635-1350.

The enumeration date for this NPI number is 2/27/2017 and was last updated on 11/3/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	DO14260	OREGON	Yes
2	261QP2300X	Clinic/Center	Primary Care			No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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