Organization
PROACTIVE HEALTH RESOURCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS VANDERVEER RN (PRESIDENT/OWNER)
(503) 342-6202
Entity
Organization
Contact information
Practice address
4077 JEFFERSON PKWY, LAKE OSWEGO, OR 97035-1478
(503) 342-6202
Mailing address
4077 JEFFERSON PKWY, LAKE OSWEGO, OR 97035-1478
(503) 342-6202
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
9142
OR
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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