Organization
CHAR GLENN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER PHILLIPS CPC (BILLING MANAGER)
(360) 667-3047
Entity
Organization
Contact information
Practice address
2525 NW LOVEJOY ST STE 405, PORTLAND, OR 97210-2865
(503) 274-9818
(503) 248-0049
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(360) 687-5221
(360) 666-0466
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0599990000
BLUE CROSS
OR
Enumeration date
04/28/2006
Last updated
11/09/2016
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