Organization
EMANUEL CHILDREN'S DIABETES AND ENDOCRINE CENTER
Active
Parent organization
LEGACY HOSPITALS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY HOSPITALS
Authorized official
LAURA NIBERT RN (MANAGER)
(503) 413-1600
Entity
Organization
Contact information
Practice address
501 N GRAHAM ST, SUITE 375, PORTLAND, OR 97227-1654
(503) 413-1600
(503) 413-1915
Mailing address
501 N GRAHAM ST, SUITE 375, PORTLAND, OR 97227-1654
(503) 413-1600
(503) 413-1915
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
200841070RN
OR
261Q00000X
Clinic/Center
RN60078715
WA
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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