Provider Demographics
NPI:1912549791
Name:OREGON PATIENT CARE COORDINATORS
Entity Type:Organization
Organization Name:OREGON PATIENT CARE COORDINATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, MBA, DHA
Authorized Official - Phone:503-875-1922
Mailing Address - Street 1:77 SW RIVERVIEW PL
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-6773
Mailing Address - Country:US
Mailing Address - Phone:503-875-1922
Mailing Address - Fax:503-749-7599
Practice Address - Street 1:77 SW RIVERVIEW PL
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-6773
Practice Address - Country:US
Practice Address - Phone:503-875-1922
Practice Address - Fax:503-749-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary RehabilitationGroup - Multi-Specialty
No2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1326698143OtherNPPES