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NPI Code Detail

MEDICARE: PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.

MEDICARE: PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063687895
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
Provider Business Mailing Address
First Line : 3727 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1112
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Provider Business Practice Location Address
First Line : 3727 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1112
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Authorized Official
Title or Position : CHEIF EXECUTIVE OFFICER
Name : MS. STACY CROSS
Credential :
Telephone Number : 503-775-4931
Provider Enumeration Date : 04/23/2008
Last Update Date : 07/22/2014

Similar Medicare Providers

1053311860 — PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC.
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285
1104874262 — DANA WENDY MOZER FNP
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285
1629094792 — ELIZABETH PAULA BANKS FNP
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285
1669491866 — NANCY MARIE GIBSON FNP
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285
1396841631 — DR. CYNTHIA K. PERRY PHD, FNP
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD , PLANNED PARENTHOOD OF THE COLUMBIA WILLAMETTE
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285
1447381165 — SARAH CAMP FNP
Practice Location Address:
3727 NE MARTIN LUTHER KING JR BLVD , ATTN: CREDENTIALING
PORTLAND, OR
97212-1112
Practice Phone: 503-775-4931
Practice Fax: 503-788-7285

Directions to “PLANNED PARENTHOOD OF THE COLUMBIA/WILLAMETTE, INC. ” Practice Location

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