Organization
PACIFIC INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PIOTR PAWEL KUKLINSKI MD (PHYSICIAN)
(503) 648-7171
Entity
Organization
Contact information
Practice address
527 SE BASELINE ST, SUITE G, HILLSBORO, OR 97123-4149
(503) 648-7171
(503) 844-6371
Mailing address
527 SE BASELINE ST, SUITE G, HILLSBORO, OR 97123-4149
(503) 648-7171
(503) 844-6371
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240076
—
OR
Enumeration date
07/11/2007
Last updated
07/11/2007
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