Organization
STARK STREET PLAZA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAMMAI ROCKOVE M.D. (MEDICAL DIRECTOR)
(503) 492-6510
Entity
Organization
Contact information
Practice address
24076 SE STARK ST, SUITE 310, GRESHAM, OR 97030-3373
(503) 492-6510
(503) 492-6502
Mailing address
24076 SE STARK ST, SUITE 310, GRESHAM, OR 97030-3373
(503) 492-6510
(503) 492-6502
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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