# THE ENDOCRINE CLINIC PC

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

## Provider details

- **NPI number:** 1255367884
- **Authorized official:** MS. TAMI L PRIDEAUX (CLINIC MANAGER)
- **Authorized official phone:** (503) 256-4096

## Contact information

- **Practice address:** 10000 SE MAIN ST, SUITE 403, PORTLAND, OR 97216-2448
- **Practice address phone:** (503) 256-4096
- **Practice address fax:** (503) 256-0101
- **Mailing address:** 10000 SE MAIN ST, SUITE 403, PORTLAND, OR 97216-2448
- **Mailing address phone:** (503) 256-4096
- **Mailing address fax:** (503) 256-0101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | MD019378 | OR | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 08/22/2020