Provider Demographics
NPI:1710036280
Name:SHERWOOD URGENT CARE & MEDICAL CENTER
Entity Type:Organization
Organization Name:SHERWOOD URGENT CARE & MEDICAL CENTER
Other - Org Name:URGENT CARE & MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:CLINIC MANAGER
Authorized Official - Phone:503-625-4100
Mailing Address - Street 1:11820 SW KING JAMES PL SUITE #30
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97224-2481
Mailing Address - Country:US
Mailing Address - Phone:503-625-4100
Mailing Address - Fax:971-245-6276
Practice Address - Street 1:11820 SW KING JAMES PL #30
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:OR
Practice Address - Zip Code:97224-2481
Practice Address - Country:US
Practice Address - Phone:503-625-4100
Practice Address - Fax:971-245-6276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR261QP2300X261QP2300X
OR261QU0200X261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care