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General NPI Number Information
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NPI Number | 1376255612
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Entity Type | Organization
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Legal Business Name | ROSECITY MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 11397 SE CASCADE VIEW CT
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-9753
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Country | US
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Telephone | 503-780-1107
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Fax |
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Provider Business Mailing Address
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Address Line | 10117 SE SUNNYSIDE RD STE F
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City | HAPPY VALLEY
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State | OR
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Zip | 97015-7708
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Country | US
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Telephone | 503-780-1107
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | RUI YANG
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Credential |
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Telephone | 503-780-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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