Organization
GLADSTONE COMMUNITY CLINIC
Active
Organization
GLADSTONE COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH E TYLER (R.N.)
(503) 850-4472
Entity
Organization
Contact information
Practice address
18911 PORTLAND AVE, GLADSTONE, OR 97027-1630
(503) 850-4472
(503) 850-4473
Mailing address
18911 PORTLAND AVE, GLADSTONE, OR 97027-1630
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
200243005RN
OR
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
Update your record
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