Provider Demographics
NPI:1114435641
Name:PARTRIDGE, MICHAEL SEAN
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SEAN
Last Name:PARTRIDGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 SW 2ND CT
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-6760
Mailing Address - Country:US
Mailing Address - Phone:503-267-8171
Mailing Address - Fax:
Practice Address - Street 1:2008 SW 2ND CT
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-6760
Practice Address - Country:US
Practice Address - Phone:503-267-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)