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General NPI Number Information
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NPI Number | 1255581625
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Entity Type | Organization
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Legal Business Name | ROSE CITY WOMEN'S HEALTH, P.C.
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 507 NE 47TH AVE STE 204
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City | PORTLAND
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State | OR
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Zip | 97213-2245
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Country | US
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Telephone | 503-215-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 507 NE 47TH AVE STE 204
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City | PORTLAND
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State | OR
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Zip | 97213-2245
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Country | US
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Telephone | 503-215-2100
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. BRIAN DRAKE
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Credential | MD
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Telephone | 503-215-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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