Provider Demographics
NPI:1073929782
Name:TUALITY MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:TUALITY MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-681-1583
Mailing Address - Street 1:335 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4246
Mailing Address - Country:US
Mailing Address - Phone:503-681-1177
Mailing Address - Fax:503-681-1923
Practice Address - Street 1:335 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4246
Practice Address - Country:US
Practice Address - Phone:503-681-1177
Practice Address - Fax:503-681-1923
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUALITY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-02
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
OR261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty