N/A – Preferred Provider Organization, NPI 1588992317
Preferred Provider Organization
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for N/A
12661, Southeast Powell Boulevard, Powellhurst-Gilbert, Portland, Metro, Multnomah County, Oregon, 97236, United States
PORTLAND, OR 972363400
Phone: (503) 853-5284
Type: Location
1441, Northwest Slocum Way, Caxton Woods, Northwest Heights, Portland, Washington County, Oregon, 97229, United States
PORTLAND, OR 972299139
Phone: (503) 853-5284
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97236)
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