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General NPI Number Information
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NPI Number | 1982008025
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Entity Type | Organization
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Legal Business Name | ONE-STOP URGENT CARE, LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 17600 SW ALEXANDER ST
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City | BEAVERTON
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State | OR
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Zip | 97003-4411
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Country | US
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Telephone | 503-848-9110
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Fax | 503-591-9122
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Provider Business Mailing Address
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Address Line | 17600 SW ALEXANDER ST
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City | BEAVERTON
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State | OR
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Zip | 97003-4411
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Country | US
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Telephone | 503-848-9110
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Fax | 503-591-9122
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLY LEAF
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Credential | MD
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Telephone | 503-848-9110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care 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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | MD22901
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License Number State | OR
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