# GRESHAM TROUTDALE FAMILY MEDICAL CENTER PC

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

## Provider details

- **NPI number:** 1225184674
- **Authorized official:** DR. GREGORY MICHAEL KNOPF MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (503) 491-2422

## Contact information

- **Practice address:** 1700 SW 257TH AVE, TROUTDALE, OR 97060-1900
- **Practice address phone:** (503) 491-2422
- **Practice address fax:** (503) 491-2434
- **Mailing address:** PO BOX 730, TROUTDALE, OR 97060-0730
- **Mailing address phone:** (503) 491-2422
- **Mailing address fax:** (503) 491-2434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 04/20/2008