Healthcare Provider Details

I. General information

NPI: 1710036280
Provider Name (Legal Business Name): SHERWOOD URGENT CARE & MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11820 SW KING JAMES PL #30
KING CITY OR
97224-2481
US

IV. Provider business mailing address

11820 SW KING JAMES PL SUITE #30
KING CITY OR
97224-2481
US

V. Phone/Fax

Practice location:
  • Phone: 503-625-4100
  • Fax: 971-245-6276
Mailing address:
  • Phone: 503-625-4100
  • Fax: 971-245-6276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number261QP2300X
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number261QU0200X
License Number StateOR

VIII. Authorized Official

Name: MRS. ANDREA M. VOLK
Title or Position: CLINIC MANAGER
Credential: CLINIC MANAGER
Phone: 503-625-4100