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Organization

THE UROLOGY CLINIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BEVERLY ANN HELLER (ADMINISTRATOR)
(503) 288-7303
Entity
Organization

Contact information

Practice address
501 N GRAHAM ST, STE 420, PORTLAND, OR 97227-1654
(503) 288-7303
(503) 280-1993
Mailing address
501 N GRAHAM ST, STE 420, PORTLAND, OR 97227-1654
(503) 288-7303
(503) 280-1993

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109371
OR
05
7858004
WA
01
CP7690
MEDICARE RAILROAD
OR
Enumeration date
10/04/2005
Last updated
07/21/2022
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