Mt Tabor Family Medical Group, PC
Mt Tabor Family Medical Group, PC is a Non-Pharmacy Dispensing Site in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2008.
- Licensed in
- OR
- In the registry since
- 2008
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
5919 SE Belmont StPortland, OR 97215-1925
Phone: (503) 234-7366
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Non-Pharmacy Dispensing Site (primary) | Taxonomy 332900000X · Licence MD12668 (OR) |
|---|
Record details
| NPI number | 1548416944 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Medvantx, Inc |
| Authorized official | Kenny Heine — Director Of Operations · (858) 625-2990 |
| NPI enumerated | August 18, 2008 |
| Last updated in NPPES | July 2, 2010 |
| Mailing address | 5810 Nancy Ridge Dr, 100, San Diego, CA 92121-2834 |
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