Organization
PACIFIC NORTHWEST RENAL SERVICES, L.L.C.
Active
Other names
PNRS-CLACKAMAS KIDNEY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FAWCETT (TREASURER)
(781) 402-9000
Entity
Organization
Contact information
Practice address
13560 SE 97TH AVE, CLACKAMAS, OR 97015-7691
(503) 659-8200
Mailing address
13560 SE 97TH AVE, CLACKAMAS, OR 97015-7691
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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