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Organization
AT HOME PRIMARY CARE LLC.
Active
Organization
AT HOME PRIMARY CARE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZIE ANNETTE DAVIS (MANAGER)
(503) 344-6717
Entity
Organization
Contact information
Practice address
6400 SE LAKE RD # 420, PORTLAND, OR 97222-2129
(503) 344-6717
Mailing address
6400 SE LAKE RD # 420, PORTLAND, OR 97222-2129
(503) 344-6717
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/19/2015
Last updated
02/12/2015
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