Organization
WOMEN'S CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYKAYE BRADY (ADMINISTRATOR)
(503) 249-5491
Entity
Organization
Contact information
Practice address
501 N GRAHAM ST, SUITE 525, PORTLAND, OR 97227-1654
(503) 249-5454
(503) 249-5498
Mailing address
501 N GRAHAM ST, SUITE 525, PORTLAND, OR 97227-1654
(503) 249-5454
(503) 249-5498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064688
—
OR
Enumeration date
08/06/2006
Last updated
11/11/2011
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