Organization
SOUTH TABOR FAMILY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONDA EVERETT (ADMINISTRATOR)
(503) 261-7200
Entity
Organization
Contact information
Practice address
10803 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Mailing address
10803 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
262417
OR
Other
Enumeration date
06/19/2006
Last updated
10/03/2012
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