Organization
INTEGRATED MEDICINE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY C HEITSCH (OWNER ADMINISTRATIVE DIRECTOR)
(503) 257-3327
Entity
Organization
Contact information
Practice address
163 NE 102ND AVE, BUILDING V, PORTLAND, OR 97220-4169
(503) 257-3327
(503) 257-3374
Mailing address
163 NE 102ND AVE, BUILDING V, PORTLAND, OR 97220-4169
(503) 257-3327
(503) 257-3374
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
OR
Other
Enumeration date
03/06/2007
Last updated
02/21/2008
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