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General NPI Number Information
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NPI Number | 1053630491
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Entity Type | Organization
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Legal Business Name | CAREOREGON COMMUNITY HEALTH, LLC
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 17175 SW TUALATIN VALLEY HWY SUITE B-2
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City | BEAVERTON
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State | OR
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Zip | 97006-4584
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Country | US
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Telephone | 503-848-5861
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Fax | 503-848-5863
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Provider Business Mailing Address
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Address Line | 315 SW 5TH AVE STE 900
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City | PORTLAND
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State | OR
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Zip | 97204-1739
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Country | US
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Telephone | 503-416-4100
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Fax | 503-416-1478
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES M. SCHROEDER
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Credential | PA
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Telephone | 503-416-5764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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