# ADVANTAGE MEDICAL GROUP LLP

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

## Provider details

- **NPI number:** 1578633616
- **Authorized official:** DR. DANIEL KEITH MANGUM DO (DO OWNER)
- **Authorized official phone:** (503) 293-1515

## Contact information

- **Practice address:** 9900 SW HALL BLVD, \#200, TIGARD, OR 97223
- **Practice address phone:** (503) 293-1515
- **Practice address fax:** (503) 595-3905
- **Mailing address:** 9900 SW HALL BLVD, \#200, TIGARD, OR 97223
- **Mailing address phone:** (503) 293-1515
- **Mailing address fax:** (503) 595-3905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 08/22/2020