Integrated Medicine Group LLC
General Practice in Portland, OR. Organization (NPI-2).
Details
- NPI
- 1033249404
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Medicine Group LLC
- Organization subpart
- No
- Enumeration date
- Mar 6, 2007
- Last updated
- Feb 21, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | OR | Yes |
Practice location
163 Ne 102nd AveBuilding V
Portland, OR 97220-4169
Phone 503-257-3327 · Fax 503-257-3374
Mailing address
163 Ne 102nd AveBuilding V
Portland, OR 97220-4169
Phone 503-257-3327 · Fax 503-257-3374
Authorized official
Christy C Heitsch
Owner Administrative Director
5032573327
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