# SELLWOOD MEDICAL CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083686554
- **Authorized official:** MORGAN MUNOZ (BUSINESS OFFICE SUPERVISOR)
- **Authorized official phone:** (503) 595-9300

## Contact information

- **Practice address:** 8332 SE 13TH AVE, PORTLAND, OR 97202-7102
- **Practice address phone:** (503) 595-9300
- **Practice address fax:** (503) 233-1892
- **Mailing address:** 8332 SE 13TH AVE, PORTLAND, OR 97202-7102
- **Mailing address phone:** (503) 595-9300
- **Mailing address fax:** (503) 233-1892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD11101 | OR | Yes |
| 207RC0000X | Cardiovascular Disease Physician | MD06704 | OR | — |
| 363A00000X | Physician Assistant | P83603 | OR | — |

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 09/20/2022