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Organization

PEDIATRIC ASSOCIATES OF GRESHAM PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NORMAN T EKI MD (PRESIDENT)
(503) 661-4200
Entity
Organization

Contact information

Practice address
2150 NE DIVISION ST STE 103, GRESHAM, OR 97030-5858
(503) 661-4200
(503) 666-0566
Mailing address
2150 NE DIVISION ST STE 103, GRESHAM, OR 97030-5858
(503) 661-4200
(503) 666-0566

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0659871-9
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0659871-9
BUSINESS ID NUMBER
OR
Enumeration date
03/06/2007
Last updated
08/22/2020
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