Organization
PROFESSIONAL HEALTH CARE LLC
Active
Other names
Get A Flu Shot.com
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HASSAN GHOLI (GENERAL MANAGER)
(503) 522-1860
Entity
Organization
Contact information
Practice address
2580 KENSINGTON CT, WEST LINN, OR 97068
(503) 258-9800
(503) 258-8311
Mailing address
2580 KENSINGTON CT, WEST LINN, OR 97068
(503) 258-9800
(503) 258-8311
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112014
MEDICARE #
OR
05
—
213900
—
OR
01
—
AB26795
MEDICARE #
WA
01
—
AB26796
MEDICARE #
WA
Enumeration date
01/11/2008
Last updated
03/24/2016
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