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General NPI Number Information
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NPI Number | 1366388209
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Entity Type | Organization
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Legal Business Name | CORNER HEALTH MEDICAL GROUP NORTHWEST, P.C.
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 10260 SW GREENBURG RD FL 4
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City | PORTLAND
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State | OR
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Zip | 97223-5500
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Country | US
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Telephone | 425-243-3719
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Fax |
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Provider Business Mailing Address
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Address Line | 10260 SW GREENBURG RD FL 4
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City | PORTLAND
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State | OR
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Zip | 97223-5500
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Country | US
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Telephone | 425-243-3719
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ANNE GIFFORD
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Credential |
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Telephone | 425-243-3719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult 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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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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 | 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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