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Organization

OREGON SCOTTISH RITE CLINICS

Active
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Organization

OREGON SCOTTISH RITE CLINICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIN HAAG (ASSOC. DIRECTOR)
(503) 226-1048
Entity
Organization

Contact information

Practice address
5125 SW MACADAM AVE, 200, PORTLAND, OR 97239-3809
(503) 226-1048
(503) 226-1049
Mailing address
5125 SW MACADAM AVE, 200, PORTLAND, OR 97239-3809
(503) 226-1048
(503) 226-1049

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
NON-PROFIT
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170100
—
OR
01
—
838353000
BLUECROSS PROVIDER
OR
Enumeration date
02/08/2007
Last updated
09/27/2010
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