Provider Demographics
NPI:1568609873
Name:MARSHALL GROUP LLC
Entity Type:Organization
Organization Name:MARSHALL GROUP LLC
Other - Org Name:MCMINNVILLE IMMEDIATE HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATTANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-883-4445
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-0887
Mailing Address - Country:US
Mailing Address - Phone:503-883-4445
Mailing Address - Fax:503-883-5831
Practice Address - Street 1:207 NE 19TH ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9927
Practice Address - Country:US
Practice Address - Phone:503-883-4445
Practice Address - Fax:503-883-5831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care