Provider Demographics
NPI:1073762449
Name:AXIS HEATHCARE
Entity Type:Organization
Organization Name:AXIS HEATHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-245-4100
Mailing Address - Street 1:10175 SW BARBUR BLVD
Mailing Address - Street 2:SUITE 105BA
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5908
Mailing Address - Country:US
Mailing Address - Phone:503-245-4100
Mailing Address - Fax:503-245-4722
Practice Address - Street 1:10175 SW BARBUR BLVD
Practice Address - Street 2:SUITE 105BA
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5908
Practice Address - Country:US
Practice Address - Phone:503-245-4100
Practice Address - Fax:503-245-4722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization