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Organization
PEDIATRIC EVENING CARE, LLC
Active
Organization
PEDIATRIC EVENING CARE, LLC
Active
Parent organization
PEDIATRIC EVENING CARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC EVENING CARE, LLC
Authorized official
CHRISTINA M GRUCELLA MD (CEO)
(503) 905-3400
Entity
Organization
Contact information
Practice address
1510 DIVISION ST STE 280, OREGON CITY, OR 97045-2550
(503) 905-3400
(503) 905-3399
Mailing address
1510 DIVISION ST STE 280, OREGON CITY, OR 97045-2550
(503) 905-3400
(503) 905-3399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD162166
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD162166
MEDICAL LICENSE
OR
Enumeration date
02/01/2018
Last updated
02/01/2018
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