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Organization
SUNSET FAMILY PRACTICE GROUP PC
Active
Organization
SUNSET FAMILY PRACTICE GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIC KRISCIUNAS MD (LEAD PHYSICIAN)
(503) 626-0939
Entity
Organization
Contact information
Practice address
12400 NW CORNELL RD, PORTLAND, OR 97229-5616
(503) 626-0939
(503) 626-6161
Mailing address
12400 NW CORNELL RD, P.O. BOX 2767, PORTLAND, OR 97229-5616
(503) 626-0939
(503) 626-6161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
06/20/2006
Last updated
07/27/2010
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