Provider Demographics
NPI:1386089308
Name:GASTROENTEROLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OF ADVENTIST HEALTH CLINICS
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-255-3054
Mailing Address - Street 1:10000 SE MAIN ST STE 112
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2441
Mailing Address - Country:US
Mailing Address - Phone:503-255-3054
Mailing Address - Fax:
Practice Address - Street 1:417 SE 164TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8944
Practice Address - Country:US
Practice Address - Phone:503-255-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty