Gresham-Troutdale Family Medical Center

NPI #1750581062 in Troutdale, Oregon

Provider Information

NPI Number
1750581062
Entity Type
Organization
Organization Name
Gresham-Troutdale Family Medical Center
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX, INC.
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Jul 24, 2007
Last Updated
Oct 22, 2012

Practice Location

Address
1700 SW 27TH AVE
State
Oregon
ZIP Code
97060
Phone
(503) 669-6800

Authorized Official

Name
KENNY HEINE
Title
DIRECTOR OF OPERATIONS
Phone
(858) 625-2990

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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