Organization
MEDICAL WELLNESS GROUP LLC
Active
Other names
The Wellness Center PDX
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE A SALHAB M.D. (OWNER)
(503) 389-5545
Entity
Organization
Contact information
Practice address
1359 NE 35TH AVENUE, PORTLAND, OR 97232
(503) 389-5545
Mailing address
6222 SOARING AVE, TEMPLE TERRACE, FL 33617-1391
(813) 765-1930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD167486
OR
207Q00000X
Family Medicine Physician
ME119290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811200165
INDIVIDUAL SOLE PROVIDER NPI
OR
01
—
R177434
MEDICARE ID
OR
Enumeration date
09/18/2014
Last updated
11/25/2014
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