Organization · NPI-2

Aaa Health Services, LLC

Family Medicine · Portland, OR

NPI number1295331304
StatusActive
Last updated in NPPESDec 5, 2020

Details

NPI
1295331304
Entity type
Organization (NPI-2)
Legal business name
Aaa Health Services, LLC
Organization subpart
No
Enumeration date
Dec 5, 2020
Certification date
Dec 5, 2020
Last updated
Dec 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

12774 Se Stark St
Portland, OR 97233-1539

Phone 503-567-6077 · Fax 503-994-0341

Mailing address

12774 Se Stark St
Portland, OR 97233-1539

Phone 503-567-6077 · Fax 503-994-0341

Authorized official

Volodymyr Golovan
Manager
5035676077

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