Organization
MD SQUARED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MILLER-DAVIS MD (PRESIDENT)
(503) 723-7234
Entity
Organization
Contact information
Practice address
22400 SALAMO RD STE 201, WEST LINN, OR 97068-8269
(503) 723-7234
Mailing address
8205 SW CREEKSIDE PL, 150, BEAVERTON, OR 97008-7108
(503) 968-2885
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD26751
OR
Other
Enumeration date
11/08/2012
Last updated
09/25/2013
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