Organization
BEAVERTON FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH HAINES (OWNER)
(503) 213-3800
Entity
Organization
Contact information
Practice address
17200 NW CORRIDOR CT, SUITE 110, BEAVERTON, OR 97006-3295
(503) 213-3800
Mailing address
17200 NW CORRIDOR CT, SUITE 110, BEAVERTON, OR 97006-3295
(503) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/01/2012
Last updated
06/25/2012
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