Lake Grove Ent Pc in Lake Oswego - Otolaryngology
Lake Grove Ent Pc - NPI 1043211824
Lake Grove Ent Pc is a Otolaryngology in Lake Oswego, Oregon. Lake Grove Ent Pc practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for Lake Grove Ent Pc is 1043211824. The last update date is 2022-04-04.
Lake Grove Ent Pc's current location address is 17704 Jean Way, Lake Oswego, Oregon. You can contact this provider via phone number 5036990370 and fax number 9712369099. The mailing address for Lake Grove Ent Pc is 17704 Jean Way, Lake Oswego, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Grove Ent Pc |
|---|---|
| Address | 17704 Jean Way, Lake Oswego, Oregon |
| Phone Number | 5036990370 |
| Fax Number | 9712369099 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CLINIC MAN |
|---|---|
| Authorized Official Name | Kruse Lee Cheryl |
| Telephone Number | 5036990370 |
NPI Number Detail
| NPI Number | 1043211824 |
|---|---|
| Provider Enumeration Date | 2005-08-03 |
| Last Updated Date | 2022-04-04 |
Provider Mailing Address Detail
| Address | 17704 Jean Way |
|---|---|
| City | Lake Oswego |
| State | Oregon (OR) |
| Post Code | 970355497 |
| Phone Number | 5036990370 |
| Fax Number | 9712369099 |
Provider's Primary Taxonomy Detail
| Speciality | Otolaryngology |
|---|---|
| Taxonomy | 207Y00000X |
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Definition: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head an |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5809 | OR | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Lake Grove Ent Pc?
The Lake Grove Ent Pc has been issued the NPI (National Provider Identifier) 1043211824 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Lake Grove Ent Pc located?
The Lake Grove Ent Pc is located at 17704 Jean Way, Lake Oswego, OR 970355497.
What is the area of specialization for Lake Grove Ent Pc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Lake Grove Ent Pc is Otolaryngology, and the corresponding taxonomy code that categorizes this area of expertise is 207Y00000X.
On what date did Lake Grove Ent Pc receive its 1043211824 assignment from the Centers for Medicare & Medicaid Services?
The Lake Grove Ent Pc was assigned its 1043211824 on 2005-08-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Lake Grove Ent Pc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Lake Grove Ent Pc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-04-04.
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