Provider Demographics
NPI:1316249394
Name:UPTOWN PROVIDERS PC
Entity type:Organization
Organization Name:UPTOWN PROVIDERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GURU
Authorized Official - Middle Name:
Authorized Official - Last Name:SANKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-744-0399
Mailing Address - Street 1:17437 BOONES FERRY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-6201
Mailing Address - Country:US
Mailing Address - Phone:503-305-6262
Mailing Address - Fax:503-305-6078
Practice Address - Street 1:17437 BOONES FERRY RD
Practice Address - Street 2:STE 100
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-6201
Practice Address - Country:US
Practice Address - Phone:503-305-6262
Practice Address - Fax:503-305-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty