Provider Demographics
NPI:1255682332
Name:ESSENTIAL HEALTH CLINIC
Entity Type:Organization
Organization Name:ESSENTIAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TZENG
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:503-974-6313
Mailing Address - Street 1:266 WEST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-3961
Mailing Address - Country:US
Mailing Address - Phone:503-846-4904
Mailing Address - Fax:503-846-4493
Practice Address - Street 1:266 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-3961
Practice Address - Country:US
Practice Address - Phone:503-846-4904
Practice Address - Fax:503-846-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty