Portland Avenue Family Clinic

LBN: Portland Avenue Clinic Management
Portland Avenue Family Clinic is an health care organization with primary practice located at 4314 E Portland Ave Suite7, Tacoma WA 98404-4696. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Portland Avenue Clinic Management can be contacted via phone (253) 476-9121, or through Leng, Poly via phone (253) 476-9121.

Contact Information

Primary practice address
4314 E Portland Ave Suite7 Tacoma WA 98404-4696
Phone: (253) 476-9121
Fax: (253) 476-8942
Website:
Map and Directions
Authorized official contact:
Name: Leng, Poly
Phone: (253) 476-9121

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X Washington

Profile Details

NPI number 1922139534
LBN Legal business name Portland Avenue Clinic Management
DBA Doing business as Portland Avenue Family Clinic
Authorized official Leng, Poly
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated Mar 5th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922139534 NPPES
Washington MEDICAID 7084163

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