Provider Demographics
NPI:1013075670
Name:HEALTHMARK INC
Entity Type:Organization
Organization Name:HEALTHMARK INC
Other - Org Name:CARDIOGRAPHICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:CCT
Authorized Official - Phone:971-236-9171
Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-1707
Mailing Address - Country:US
Mailing Address - Phone:971-236-9171
Mailing Address - Fax:971-236-9180
Practice Address - Street 1:8305 SE MONTEREY AVE STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97086-7728
Practice Address - Country:US
Practice Address - Phone:971-236-9171
Practice Address - Fax:971-236-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR110538Medicare ID - Type Unspecified