NPI 1043488166

Miranda McCormack, M.D., LLC

Organisation Primary Care Clinic/Center Beaverton, OR

Practice location

Address: 5040 SW Griffith Dr #201, Beaverton, OR 97005-2985
Phone: (503) 616-2224

Authorised official

Name: Miranda Christie McCormack
Title: Physician/Owner
Phone: (503) 616-2224

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence 465592-90 (OR)

Other Clinic/Center providers in Oregon →

Registry record

NPI: 1043488166
Entity type: Organization
NPI issued: 11 Feb 2008
Record last updated: 11 Feb 2008

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.