Provider Demographics
NPI:1548774375
Name:SEASONS MEDICAL GROUP OF OREGON PC
Entity Type:Organization
Organization Name:SEASONS MEDICAL GROUP OF OREGON PC
Other - Org Name:ACCENTCARE MEDICAL GROUP OF OREGON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-692-1148
Mailing Address - Street 1:6400 SHAFER CT STE 300A
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6500 SW MACADAM AVE STE 160
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3566
Practice Address - Country:US
Practice Address - Phone:866-238-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty