Organization Name: | UNIVERSITY PROFESSIONAL SERVICES |
NPI Number: | 1255722260 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS A. HECKLER (ASSOCIATE DEAN) |
Mailing Address: | 3181 Sw Sam Jackson Park Rd Portland |
State: | OR US |
Postal Code: | 972393011 |
Phone Number: | 5034184500 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2015 |
NPI Last Update Date: | 02/12/2015 |
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: |