Organization
LEGACY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA LOOMIS (CFO)
(503) 415-5730
Entity
Organization
Contact information
Practice address
2801 N GANTENBEIN AVE RM B045, PORTLAND, OR 97227-1623
(503) 413-2762
(503) 413-4671
Mailing address
PO BOX 2868, PORTLAND, OR 97208-2868
(503) 413-2762
(503) 413-4671
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/26/2016
Last updated
12/10/2020
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