Organization
NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC
Active
Other names
Oregon Kidney and Hypertension Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DERON FRANK (GENERAL MANAGER, VICE PRESIDENT)
(310) 536-2402
Entity
Organization
Contact information
Practice address
15895 SW 72ND AVE STE 250, BLDG B, TIGARD, OR 97224-7966
(503) 624-5630
(503) 624-9149
Mailing address
2000 16TH ST, DENVER, CO 80202
(303) 876-7253
(866) 917-5396
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OMAP006021
—
OR
Enumeration date
06/25/2006
Last updated
09/13/2012
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