Organization
EAST PORTLAND PEDIATRIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH SEIFERT (CLINIC MANAGER)
(503) 255-3544
Entity
Organization
Contact information
Practice address
10000 SE MAIN ST, SUITE 105, PORTLAND, OR 97216-2448
(503) 255-3544
(503) 251-6827
Mailing address
10000 SE MAIN ST, SUITE 30, PORTLAND, OR 97216-2448
(503) 255-3544
(503) 251-6827
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042309
—
OR
Enumeration date
11/02/2005
Last updated
08/22/2013
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