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Organization
NORTHWEST PRIMARY CARE GROUP, PC
Active
Organization
NORTHWEST PRIMARY CARE GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WHITBECK (ADMINISTRATOR)
(503) 659-4777
Entity
Organization
Contact information
Practice address
12300 SE MALLARD WAY, SUITE 160, MILWAUKIE, OR 97222-4616
(503) 659-4777
(503) 652-5223
Mailing address
PO BOX 22075, MILWAUKIE, OR 97269-2075
(503) 659-4777
(503) 652-5223
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/25/2007
Last updated
06/03/2020
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