PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE , NPI 1609298967
Clinic/Center in PORTLAND, OR
Last Updated on : Dec 30,2014
About PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE (NPI 1609298967)
PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE (PROVIDENCE HEALTH & SERVICES - OREGON) is a Clinic/Center in PORTLAND, United States .
1609298967 is NPI number of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE.
PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE's primary taxonomy code based on NPI Lookup is 261Q00000X with license number . This taxonomy code refers to Clinic/Center.
PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE current practice location address is PO BOX 3158, PORTLAND, OR.
You can also correspond with PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE through mail at mailing address 9290 SE SUNNYBROOK BLVD, CLACKAMAS, OR, United States. Mailing address contact number is 503-823-6525.
The enumeration date of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE is 06-Jan-2014. The provider is registered as an Organization and the NPI record was last updated 9 years ago. The authorized official of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE is Keenan Freeman (CFO). Keenan Freeman can be reached at 5038936524.1609298967 NPI Information
Basic NPI information of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE (NPI 1609298967) is provided below.
| Name | PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE |
|---|---|
| National Provider Id (NPI) | 1609298967 |
| Entity Type | Organization |
| Practice Address | PO BOX 3158,
PORTLAND, OR, United States |
| Practice Telephone | |
| Practice Fax Number | |
| Mailing Address | 9290 SE SUNNYBROOK BLVD ,
SUITE 120
CLACKAMAS, OR, United States |
| Mailing Telephone | 503-823-6525 |
| Mailing Fax Number | |
| Enumeration Date | 06-Jan-2014 |
| Last Updated Date | 30-Dec-2014 |
PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE (NPI 1609298967) Primary Taxonomy Information
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs, the license data is associated to the taxonomy code.
| Primary | Taxonomy Code | Clasification | License Number | License State |
|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type/Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| R0000WCRBF | MEDICARE PIN (08) | OR |
PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE (NPI 1609298967) Office Location
Office location of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE is provided in the Google maps below.Providers in same location
Here are a few of the other providers in the same location.
| NPI | Name | Taxonomy | Address | Enumeration date |
|---|---|---|---|---|
| 1013159557 | KARA ELIZABETH MORGAN | Dentist, General Practice | P.O. BOX 365,
PORTLAND, AR, United States |
30-Mar-2009 |
| 1578681342 | JUANITA B TURNER | Social Worker | PO BOX 413,
PORTLAND, AR, United States |
27-Mar-2007 |
| 1578770582 | PORTLAND DRUG INC. | Pharmacy, Community/Retail Pharmacy | PO BOX 246,
PORTLAND, AR, United States |
17-May-2007 |
| 1548425200 | MELISSA BROOKS SELBY | Physical Therapy Assistant | PO BOX 412,
2196 ASHLEY 69 ROAD HAMBURG PORTLAND, AR, United States |
22-Jul-2008 |
| 1174637896 | BRENDA FOWLER | Nurse Practitioner, Community Health | PO BOX 100,
PORTLAND, AR, United States |
19-Aug-2006 |
| 1962518795 | MAINLINE HEALTH SYSTEMS, INC | Clinic/Center | PO BOX 100,
PORTLAND, AR, United States |
22-Aug-2006 |
| 1033139068 | MARY ELIZABETH SWIHART | Nurse Practitioner, Family | 3900 S ZINTEL WAY FL 2,
KENNEWICK, WA, United States |
20-Jul-2006 |
| 1891809547 | MAINLINE HEALTH SYSTEMS INC | Clinic/Center, Federally Qualified Health Center (FQHC) | 203 MCCOMB ST,
WILMOT, AR, United States |
19-Aug-2006 |
| 1386758043 | MAINLINE HEALTH SYSTEMS INC | Clinic/Center, Federally Qualified Health Center (FQHC) | PO BOX 100,
PORTLAND, AR, United States |
19-Aug-2006 |
| 1619082724 | MAINLINE HEALTH SYSTEMS, INC | Clinic/Center, Federally Qualified Health Center (FQHC) | PO BOX 100,
PORTLAND, AR, United States |
20-Aug-2006 |
| 1952405524 | MAINLINE HEALTH SYSTEMS, INC | Clinic/Center, Dental | 203 MCCOMB ST,
WILMOT, AR, United States |
12-Sep-2006 |
| 1316106388 | MAINLINE HEALTH SYSTEMS INC | Clinic/Center, Federally Qualified Health Center (FQHC) | 233 N MAIN ST,
PORTLAND, AR, United States |
05-Jun-2008 |
| 1396074886 | AMY FLOYD | Social Worker, Clinical | 233 NORTH MAIN,
PORTLAND, AR, United States |
14-Dec-2009 |
| 1376841247 | BYRON K MONTGOMERY | Nurse Practitioner | 233 N MAIN ST,
PORTLAND, AR, United States |
02-Mar-2011 |
| 1942611504 | PORTLAND DRUG LLC | Pharmacy, Community/Retail Pharmacy | 105 HIGHWAY 165 S,
PORTLAND, AR, United States |
16-May-2014 |
| 1649636986 | MAINLINE HEALTH SYSTEMS, INC | Clinic/Center, Federally Qualified Health Center (FQHC) | PO BOX 509,
DERMOTT, AR, United States |
31-Dec-2015 |
| 1982128096 | MYRA BROOKE FLEMISTER | Nurse Practitioner, Primary Care | 233 N MAIN ST,
PORTLAND, AR, United States |
31-Jul-2017 |
| 1659034643 | JORDAN MACKENZIE YOUNG | Pharmacist | PO BOX 73,
PORTLAND, AR, United States |
18-Oct-2021 |
| 1043966500 | RILEY BAIN YOUNG | Occupational Therapy Assistant | 2935 LOCKCREST ST,
HOUSTON, TX, United States |
23-Feb-2022 |
| 1124472055 | STUART MALCOLM | Student in an Organized Health Care Education/Training Program | 601 SW 4TH AVE,
PORTLAND, CA, United States |
18-Apr-2016 |
How to check whether NPI 1063496693 is valid?
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FAQs
Whose NPI Number is 1609298967?1609298967 is the NPI number of PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE.
Where is PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE located?PROVIDENCE MEDICAL GROUP OREGON CITY GENERAL SURGERY AT SUNNYSIDE is located at PO BOX 3158, PORTLAND, OR.
NPI number meaning
| Field Name | Field Value |
|---|---|
| NPI | 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. |
| Entity Type | Code describing the type of health care provider that is being assigned an NPI.
Codes are:
|
| Provider Business Mailing Address | The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code. |
| Provider Business Mailing Address Telephone Number | The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number". |
| Provider Business Mailing Address Fax Number | The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''. |
| Provider Business Practice Location Address Telephone Number | The telephone number associated with the location address of the provider being identified. |
| Provider Business Practice Location Address Fax Number | The fax number associated with the location address of the provider being identified. |
| Provider Enumeration Date | The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date | The date that a record was last updated or changed. |
| Authorized Official Telephone Number | The 10-position telephone number of the authorized official. |
| Healthcare Provider Taxonomy Code | The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. |
| Healthcare Provider Taxonomy | Taxonomy Description of the Healthcare Provider. |
| Provider License Number | Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. |
| Provider License Number State Code | Provider License Number State Code #1 |
| Healthcare Provider Primary Taxonomy Switch | Primary Taxonomy:
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