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General NPI Number Information
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NPI Number | 1417098773
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Entity Type | Organization
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Legal Business Name | ORCHID OAKRIDGE CLINIC, PC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 37400 BELL ST
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City | SANDY
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State | OR
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Zip | 97055-7868
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Country | US
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Telephone | 971-220-2701
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 546
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City | GRESHAM
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State | OR
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Zip | 97030-0132
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Country | US
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Telephone | 503-782-8242
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Fax | 503-862-5060
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | ARIANA LEE
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Credential |
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Telephone | 971-373-4165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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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 | 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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