Organization
AMBULATORY SURGICAL CENTER
Active
Other names
Aesthetic Breast and Cosmetic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD V DEMARS MD (ADMINISTRATOR)
(503) 253-3458
Entity
Organization
Contact information
Practice address
10201 SE MAIN ST STE 20, PORTLAND, OR 97216-2937
(503) 253-3458
(503) 253-0856
Mailing address
10201 SE MAIN ST STE 20, PORTLAND, OR 97216-2937
(503) 253-3458
(503) 253-0856
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071438
OR
Other
Enumeration date
07/29/2006
Last updated
06/13/2008
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