Organization · NPI-2
360 Pelvic Health Institute LLC
Urology · Gresham, OR
NPI number1467112748
StatusActive
Last updated in NPPESDec 28, 2021
Details
- NPI
- 1467112748
- Entity type
- Organization (NPI-2)
- Legal business name
- 360 Pelvic Health Institute LLC
- Organization subpart
- No
- Enumeration date
- Dec 28, 2021
- Certification date
- Dec 28, 2021
- Last updated
- Dec 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
| 207V00000X | Obstetrics & Gynecology | – | – | |
| 2088F0040X | Urology, Urogynecology and Reconstructive Pelvic Surgery | – | – |
Practice location
24076 Se Stark StSuite 310
Gresham, OR 97030
Phone 503-492-6510
Mailing address
24076 Se Stark StSuite 310
Gresham, OR 97030
Phone 503-492-6510
Authorized official
Melanie Ann Crites Bachert
Founder And President
5034926510
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.