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Organization

THE OREGON CLINIC, PC

Active
Other names
The Oregon Clinic OBGYN
Organization subpart
No

Provider details

NPI number
Authorized official
CRAIG S FAUSEL MD (CEO/PRESIDENT)
(503) 963-2801
Entity
Organization

Contact information

Practice address
5050 NE HOYT ST, SUITE 421, PORTLAND, OR 97213-2991
(503) 935-8445
(503) 935-8446
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
160412
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500668062
OR
Enumeration date
09/25/2013
Last updated
03/10/2014
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