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Organization

SURGICAL SPECIALTY GROUP PC

Active
Other names
The Colon & Rectal Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. OLGA MARIA VEIS (CLINIC MANAGER)
(503) 222-1615
Entity
Organization

Contact information

Practice address
511 SW 10TH AVENUE, SUITE 714, PORTLAND, OR 97205-2708
(503) 222-1615
(503) 222-0016
Mailing address
511 SW 10TH AVENUE, SUITE 714, PORTLAND, OR 97205-2708
(503) 222-1615
(503) 222-0016

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084061
OR
Enumeration date
11/14/2006
Last updated
11/05/2013
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