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LEGACY CLINICS LLC

Other Service Providers Midwife

Provider NPI: 1902827272

Organization Information:
Organization Name:  LEGACY CLINICS LLC
Organization is not Subpart
Authorized Official:  SARAH  JENSEN  INTERIM CFO  503-415-5145

Practice Location:
1130 NW 22ND AVE STE 220  PORTLAND, OR 97210-2969 US
Tel: 503-413-2901  Fax: --

Business Mailing Address:
PO BOX 3777  PORTLAND, OR 97208-3777 US
Tel: 503-413-3958  Fax: 503-413-3212

NPI Information:
NPI: 1902827272
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N176B00000XOther Service Providers
Midwife
N207Q00000XPhysicians
Family Medicine
N207QG0300XPhysicians
Family Medicine
N207R00000XPhysicians
Internal Medicine
N207RC0200XPhysicians
Internal Medicine
N207T00000XPhysicians
Neurological Surgery
N207VM0101XPhysicians
Obstetrics & Gynecology
N207VX0000XPhysicians
Obstetrics & Gynecology
N207X00000XPhysicians
Orthopaedic Surgery
N2083P0901XPhysicians
Preventive Medicine
N2085R0202XPhysicians
Radiology
N2086S0129XPhysicians
Surgery
N208D00000XPhysicians
General Practice
N208M00000XPhysicians
Hospitalist
Y261QM1300XAmbulatory Health Care Facilities
Clinic/Center
OR698327-81

Other Provider Identifiers:

IssuerNumberStateType
7130628WA05
286822OR05
277776OR05
227592OR05
286709OR05
227692OR05
7101124WA05
9646449WA05
226982OR05
286482OR05
134334OR05
7098429WA05
022930OR05
286717OR05
277799OR05
REGENCE BLUE CROSS804702000OR01



American Medical Association 2012 taxonomy code information

Code: 261QM1300X

Type:

Classification:



Definition:



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