Organization
CHILDREN'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BENNETT (ADMINISTRATIVE DIRECTOR)
(503) 655-7725
Entity
Organization
Contact information
Practice address
1713 PENN LANE, OREGON CITY, OR 97045
(503) 655-7725
(503) 655-7720
Mailing address
1713 PENN LANE, OREGON CITY, OR 97045
(503) 655-7725
(503) 655-7720
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
OR
2080C0008X
Child Abuse Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227261
—
OR
Enumeration date
03/06/2008
Last updated
02/16/2016
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