NPI 1275787780

Physician on Duty

Organisation General Practice Physician Beaverton, OR

Practice location

Address: 14805 SW Blanton St., Beaverton, OR 97007
Phone: (503) 957-9632

Authorised official

Name: Sandra L Jolly
Title: Billing Manager
Phone: (503) 726-4685

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Oregon →

Registry record

NPI: 1275787780
Entity type: Organization
NPI issued: 11 Nov 2008
Record last updated: 11 Nov 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.