Organization
MOORE CARE PROVIDERS
Active
Organization
MOORE CARE PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT G BENNER (CEO)
(503) 442-6546
Entity
Organization
Contact information
Practice address
1675 SW MARLOW AVE, PORTLAND, OR 97225-5104
(503) 442-6546
Mailing address
1675 SW MARLOW AVE, PORTLAND, OR 97225-5104
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD12769
OR
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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