Organization
PEDIATRIC EVENING CARE, LLC
Active
Parent organization
PEDIATRIC EVENING CARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC EVENING CARE, LLC
Authorized official
CHRISTINA M GRUCELLA MD (CEO)
(503) 905-3400
Entity
Organization
Contact information
Practice address
1510 DIVISION ST STE 280, OREGON CITY, OR 97045-2550
(503) 905-3400
(503) 905-3399
Mailing address
1510 DIVISION ST STE 280, OREGON CITY, OR 97045-2550
(503) 905-3400
(503) 905-3399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD162166
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD162166
MEDICAL LICENSE
OR
Enumeration date
02/01/2018
Last updated
02/01/2018
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