Oregon City Medical Nw, INC

NPI #1760869739 in Tualatin, Oregon

Provider Information

NPI Number: 1760869739
Entity Type: Organization
Organization Name: Oregon City Medical Nw, INC
Primary Specialty: Clinic/Center
Enumeration Date: Apr 29, 2015
Last Updated: Apr 29, 2015

Practice Location

Address: 6464 SW BORLAND ROAD #D-4
City: Tualatin
State: Oregon
ZIP Code: 97062
Phone: (503) 487-3001

Authorized Official

Name: DANIELLE BLACKWELL, FNP
Title: FNP/OWNER
Phone: (503) 656-9030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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