Organization
PACIFIC HEALTHCARE PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANE BETH WADSWORTH (INSURANCE COORDINATOR)
(503) 312-2279
Entity
Organization
Contact information
Practice address
14355 SW ALLEN BLVD STE 130, BEAVERTON, OR 97005-4700
(503) 956-9432
Mailing address
6107 SW MURRAY BLVD STE 516, BEAVERTON, OR 97008-4421
(503) 956-9432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639113590
NPI
OR
Enumeration date
04/22/2022
Last updated
04/22/2022
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