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General NPI Number Information
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NPI Number | 1184451254
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Entity Type | Organization
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Legal Business Name | ALTEA MEDICAL OREGON LLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 127 NE 102ND AVE STE A
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City | PORTLAND
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State | OR
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Zip | 97220-4152
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Country | US
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Telephone | 971-978-1268
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E RIVULON BLVD STE 103
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City | GILBERT
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State | AZ
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Zip | 85297-0096
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MARY BELEN ARNDT
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Credential |
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Telephone | 775-287-3290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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