Lake Grove Family Medical Clinic LLC
NPI #1366982258 in Lake Oswego, Oregon
Provider Information
- NPI Number
- 1366982258
- Entity Type
- Organization
- Organization Name
- Lake Grove Family Medical Clinic LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Feb 27, 2017
- Last Updated
- Nov 3, 2020
Practice Location
- Address
- 16463 BOONES FERRY RD
- Address 2
- SUITE 100
- City
- Lake Oswego
- State
- Oregon
- ZIP Code
- 97035-4259
- Phone
- (503) 635-1350
Authorized Official
- Name
- SHANNON K SABINS
- Title
- ASSISTANT CLINIC MANAGER
- Phone
- (503) 635-1350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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