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NPI Code Detail

MEDICARE: UNIVERSITY PROFESSIONAL SERVICES

MEDICARE: UNIVERSITY PROFESSIONAL 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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1659605707
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY PROFESSIONAL SERVICES
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line : MAIL CODE UMG
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-8417
Fax Number :
Provider Business Practice Location Address
First Line : 2858 EBERLEIN AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603-4402
Country : US
Telephone Number : 503-494-9000
Fax Number :
Authorized Official
Title or Position : ASSOCIATE DEAN
Name : TOM HECKLER
Credential :
Telephone Number : 503-494-4481
Provider Enumeration Date : 09/22/2009
Last Update Date : 09/22/2009

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Directions to “UNIVERSITY PROFESSIONAL SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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