# MT HOOD WOMEN'S HEALTH PC

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

## Provider details

- **NPI number:** 1801968086
- **Authorized official:** ELAINE J BEEBLE ADMINISTRATOR (ADMINISTRATOR)
- **Authorized official phone:** (503) 491-9444

## Contact information

- **Practice address:** 24850 SE STARK ST, SUITE 200, GRESHAM, OR 97030
- **Practice address phone:** (503) 491-9444
- **Practice address fax:** (503) 661-1420
- **Mailing address:** 24850 SE STARK ST.,, SUITE 200, GRESHAM, OR 97030
- **Mailing address phone:** (503) 491-9444
- **Mailing address fax:** (503) 661-1420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 12-00004737 | OR | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 01/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 278550 | — | OR |