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Contact Information

NORTHWEST PRIMARY CARE GROUP, PC
12300 SE MALLARD WAY
SUITE 160
MILWAUKIE, OR97222-4616
 Phone: 503-659-4777
 Fax: 503-652-5223
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Family

363LF0000X 50 Nurse Practitioner
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Sleep Disorder Diagnostic

261QS1200X
Indicates primary specialty

NPI Profile & details for NORTHWEST PRIMARY CARE GROUP, PC

NPI # 1558572180
LBN Legal business name NORTHWEST PRIMARY CARE GROUP, PC
Authorized official MICHAEL WHITBECK - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/25/2007
Last updated 06/03/2020 - About 6 years ago
Identifiers
OR Medicaid 022990
OR Medicaid 049072
OR Medicaid 226666
OR Medicaid 226667
OR Medicaid 230426
OR Medicaid 274689
OR Medicaid 500620283
OR Medicaid 500620284
OR Other 38D0624596 CLIA
OR Other 38D0624619 CLIA
OR Other 38D0888269 CLIA
OR Other 38D1059196 CLIA
OR Other CE8055 RAILROAD GROUP PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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