Provider Demographics
NPI:1366583460
Name:WOMEN'S HEALTH ESSENTIALS
Entity type:Organization
Organization Name:WOMEN'S HEALTH ESSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-614-0602
Mailing Address - Street 1:12442 SW SCHOLLS FERRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-3396
Mailing Address - Country:US
Mailing Address - Phone:503-614-0602
Mailing Address - Fax:503-617-4549
Practice Address - Street 1:12442 SW SCHOLLS FERRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-3396
Practice Address - Country:US
Practice Address - Phone:503-614-0602
Practice Address - Fax:503-617-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10764174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR232843Medicaid
OR232843Medicaid
OR115924Medicare ID - Type Unspecified