NPI: 1316449168 · PORTLAND, OR 97225 · Ambulatory Surgical Clinic/Center · NPI assigned 03/07/2018
| Authorized Official | DUDLEY, BRUCE (CHIEF ADMINISTRATIVE OFFICER) |
| NPI Enumeration Date | 03/07/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 19 | $516.25 |
| 2023 | 102 | $0.00 |
| 2024 | 140 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4649 | Surgical supply; miscellaneous | 261 | 209 | $516.25 |