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General NPI Number Information
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NPI Number | 1427662204
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Entity Type | Organization
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Legal Business Name | EDMUND H. TORKELSON DO, PC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 1960 NW 167TH PL STE 204
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City | BEAVERTON
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State | OR
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Zip | 97006-4804
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Country | US
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Telephone | 503-614-8735
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Fax | 503-614-8749
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Provider Business Mailing Address
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Address Line | 1960 NW 167TH PL STE 204
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City | BEAVERTON
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State | OR
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Zip | 97006-4804
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Country | US
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Telephone | 503-614-8735
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Fax | 503-614-8749
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | MRS. ANN MARIE TORKELSON
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Credential | RN
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Telephone | 503-614-8735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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