NPI 1003914243

Stark Street Plaza, LLC

Organisation Ambulatory Surgical Clinic/Center Gresham, OR

Practice location

Address: 24076 SE Stark St Suite 310, Gresham, OR 97030-3373
Phone: (503) 492-6510
Fax: (503) 492-6502

Authorised official

Name: Shammai Rockove
Title: Medical Director
Phone: (503) 492-6510

Registered specialties

Ambulatory Surgical Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QA1903X

Other Clinic/Center providers in Oregon →

Registry record

NPI: 1003914243
Entity type: Organization
NPI issued: 20 Sep 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.