Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BLUE LAKE ORAL AND MAXILLOFACIAL SURGERY, PC
Active OrganizationBLUE LAKE ORAL AND MAXILLOFACIAL SURGERY, PC is a Oral and Maxillofacial Surgery Clinic organization located in GRESHAM, Oregon. NPI 1316535339 is currently active in the NPPES registry. Verify at CMS.
Oral and Maxillofacial Surgery Clinic · GRESHAM, OR
Registration Details
- NPI Number
- 1316535339
- Provider Type
- Organization
- NPI Issued
- Jan 5, 2021 (5.4230830495383 yrs)
- Last Updated
- Jan 18, 2021
Practice Information
- Address
-
1201 SE 223RD AVE STE 180GRESHAM, OR, 970302577Browse OR providers · Browse ZIP 97030
- Phone
- 5036671431
- Primary Specialty
-
Oral and Maxillofacial Surgery Clinic
261QS0112X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.