Healthcare Provider Details

I. General information

NPI: 1750475711
Provider Name (Legal Business Name): EMERGENCY AND ACUTE CARE MEDICAL COMPANY - NORTHWEST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LEGACY MOUNT HOOD MEDICAL CENTER 24800 SE START STREET
GRESHAM OR
97030
US

IV. Provider business mailing address

PO BOX 9350
RANCHO SANTA FE CA
92067-4350
US

V. Phone/Fax

Practice location:
  • Phone: 503-674-1122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR LAWRENCE GRUEN
Title or Position: PRESIDENT AND CEO
Credential: M.D., FACEP
Phone: 858-759-4765