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Contact Information

RIVER MEDICAL CLINIC PC
13021 SE RIVER RD
PORTLAND, OR97222-8062
 Phone: 360-260-8225
 Fax: 360-397-0189
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for RIVER MEDICAL CLINIC PC · (Female)

NPI Number 1023226271
Status Active
Credentials
Entity Individual
Enumeration date 05/20/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # MD15086
  • OR Medicaid 196295
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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