Organization
SEASIDE URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN STEFANELLI (PRACTICE MANAGER)
(503) 738-9112
Entity
Organization
Contact information
Practice address
580 AVENUE U, SEASIDE, OR 97138-5065
(503) 738-9112
Mailing address
580 AVENUE U, SEASIDE, OR 97138-5065
(503) 738-9112
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD19990
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029026
—
OR
05
—
130263
—
OR
Enumeration date
02/02/2008
Last updated
02/02/2008
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