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NPI Code Detail

MEDICARE: WOMENS HEALTHCARE SERVICES

MEDICARE: WOMENS HEALTHCARE SERVICES
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

General Provider Information

NPI Number : 1073180907
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOMENS HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : PO BOX 657
Second Line :
City : NEWBERG
State : OR
Zip : 97132-0657
Country : US
Telephone Number : 503-885-0228
Fax Number : 503-862-2102
Provider Business Practice Location Address
First Line : 3323 SW NAITO PKWY
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4672
Country : US
Telephone Number : 503-885-0228
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JENNIFER GALLARDO
Credential : CPM
Telephone Number : 503-998-4627
Provider Enumeration Date : 06/09/2021
Last Update Date : 06/09/2021

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