Pacific Medical Group, Pc

LBN: Pacific Medical Group, Pc
Pacific Medical Group, Pc is an health care organization with primary practice located at 6 Centerpointe Drive, Ste 200 , Lake Oswego OR 97035. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Pacific Medical Group, Pc can be contacted via phone (503) 234-6381, or through Clack, Susan M via phone (503) 598-2000.

Contact Information

Primary practice address
6 Centerpointe Drive, Ste 200 Lake Oswego OR 97035
Fax: (503) 234-8151
Website:
Authorized official contact:
Name: Clack, Susan M Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X Oregon

Profile Details

NPI number 1477636561
LBN Legal business name Pacific Medical Group, Pc
DBA Doing business as
Authorized official Clack, Susan M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2006
Last updated Nov 20th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477636561 NPPES
Oregon MEDICAID 230547
Oregon Other CC6737
Oregon MEDICAID 230548
Oregon MEDICAID 230549
Oregon MEDICAID 230550
Oregon MEDICAID 230589

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