# NORTHWEST PRIMARY CARE GROUP, PC

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

## Provider details

- **NPI number:** 1558572180
- **Authorized official:** MICHAEL WHITBECK (ADMINISTRATOR)
- **Authorized official phone:** (503) 659-4777

## Contact information

- **Practice address:** 12300 SE MALLARD WAY, SUITE 160, MILWAUKIE, OR 97222-4616
- **Practice address phone:** (503) 659-4777
- **Practice address fax:** (503) 652-5223
- **Mailing address:** PO BOX 22075, MILWAUKIE, OR 97269-2075
- **Mailing address phone:** (503) 659-4777
- **Mailing address fax:** (503) 652-5223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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