Providence Medical Group Glisan Dermatology At Milwaukie

LBN: Providence Health & Services - Oregon
Providence Medical Group Glisan Dermatology At Milwaukie is an health care organization with primary practice located at 10202 Se 32Nd Ave Suite 702, Milwaukie OR 97222-3625. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 215-9080, or through Freeman, Keenan B via phone (503) 893-6524.

Contact Information

Primary practice address
10202 Se 32Nd Ave Suite 702 Milwaukie OR 97222-3625
Phone: (503) 215-9080
Fax: (503) 215-9099
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan B
Phone: (503) 893-6524

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1396149225
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Medical Group Glisan Dermatology At Milwaukie
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Oct 21st, 2014
Last updated Oct 21st, 2014 - about 12 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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