Organization
EMERALD FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMERALD MANSFIELD (OWNER)
(503) 567-9355
Entity
Organization
Contact information
Practice address
819 SE MORRISON ST, STE 115, PORTLAND, OR 97214-6307
(503) 956-9396
(866) 883-0582
Mailing address
5719 SE 72ND AVE, PORTLAND, OR 97206-5811
(503) 567-9355
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
10/21/2016
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