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Organization

SHAMROCK MEDICAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LYNDA JEAN SCHWAB (MANAGER)
(503) 233-5055
Entity
Organization

Contact information

Practice address
3620 SE POWELL BLVD, PORTLAND, OR 97202-1880
(503) 233-5055
(503) 234-6974
Mailing address
3620 SE POWELL BLVD, PORTLAND, OR 97202-1880
(503) 233-5055
(503) 234-6974

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
082081000
REGENCE BLUE CROSS
OR
05
207824
OR
Enumeration date
11/21/2006
Last updated
06/16/2009
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