Organization Name: | PRESTO QUALITY CARE, INC. |
NPI Number: | 1174862957 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS PAUL STANFORD (PRESIDENT) |
Mailing Address: | 105 Se 18th Ave Portland |
State: | OR US |
Postal Code: | 972141559 |
Phone Number: | 5032815100 |
Fax Number: | 5035172055 |
NPI Enumeration Date: | 02/13/2013 |
NPI Last Update Date: | 02/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |