Provider Demographics
NPI:1376255612
Name:ROSECITY MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:ROSECITY MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUI
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-780-1107
Mailing Address - Street 1:10117 SE SUNNYSIDE RD STE F
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7708
Mailing Address - Country:US
Mailing Address - Phone:503-780-1107
Mailing Address - Fax:
Practice Address - Street 1:11397 SE CASCADE VIEW CT
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-9753
Practice Address - Country:US
Practice Address - Phone:503-780-1107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care