Lake Grove Ent Pc

LBN: Lake Grove Ent Pc
Lake Grove Ent Pc is an health care organization with primary practice located at 17704 Jean Way Ste 101, Lake Oswego OR 97035-5497. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as the primary health care specialty. Lake Grove Ent Pc can be contacted via phone (503) 699-0370, or through Kruse, Cheryl Lee via phone (503) 699-0370.

Contact Information

Primary practice address
17704 Jean Way Ste 101 Lake Oswego OR 97035-5497
Phone: (503) 699-0370
Fax: (971) 236-9099
Website:
Map and Directions
Authorized official contact:
Name: Kruse, Cheryl Lee
Phone: (503) 699-0370

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X

Profile Details

NPI number 1043211824
LBN Legal business name Lake Grove Ent Pc
DBA Doing business as
Authorized official Kruse, Cheryl Lee
Entity Organization
Organization subpart 1 No
Enumeration date Aug 3rd, 2005
Last updated Apr 4th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1043211824 NPPES
Oregon MEDICAID 005809

Popular Providers