THE PORTLAND CLINIC LABORATORY (NPI# 1053448795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053448795 |
| Entity Type | Organization |
| Organization Name | THE PORTLAND CLINIC LABORATORY |
| Practice Address |
800 Sw 13th Ave Portland OR 97205 |
| Practice Telephone | 5032210161 |
| Practice Fax Number | 5032741697 |
| Mailing Telephone | 5032210161 |
| Mailing Fax Number | 5032741697 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-10-26 |
| Authorized Official Name | MR. DICK CLARK (CEO) |
| Authorized Official Telephone | 5032210161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | CLIA | 38D06235 | 01 |
| Street Address |
800 SW 13TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235129891 | Cristina Fe G Mondragon | Internal Medicine | 800 Sw 13th Ave, Portland, OR 97205-1902 | 2005-10-25 |
| 1407407489 | Chandni Patel | Pharmacist | 800 Sw 13th Ave, Portland, OR 97205-1999 | 2019-09-22 |
| 1588148381 | Chelsea Saettone | Social Worker | 800 Sw 13th Ave, Portland, OR 97205-1999 | 2018-09-18 |
| 1952888281 | Amanda Welter | Physical Therapist | 800 Sw 13th Ave, Portland, OR 97205-1902 | 2018-07-19 |
| 1265936058 | Alexander Bulochnik Shteynberg | Pharmacist | 800 Sw 13th Ave, Portland, OR 97205-1999 | 2018-03-19 |
| 1851825640 | Pooja Naik | Internal Medicine | 800 Sw 13th Ave, Portland, OR 97205-1902 | 2017-04-18 |
| 1376906669 | Thomas Dudrey | Internal Medicine | 800 Sw 13th Ave, Portland, OR 97205-1999 | 2016-04-04 |
| 1497125884 | Stephanie Nicole D'andrea | Nurse Practitioner | 800 Sw 13th Ave, Portland, OR 97205-1999 | 2015-09-29 |
| 1255745097 | Laura Chan | Pharmacist | 800 Sw 13th Ave, Portland, OR 97205-1902 | 2014-06-19 |
| 1407199094 | Yasuyo Diana Umene | Internal Medicine | 800 Sw 13th Ave, Portland, OR 97205-1902 | 2013-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1114374949 | Elizabeth Alire | Counselor | 1411 Sw Morrison St., Portland, OR 97205 | 2016-05-23 |
| 1508237462 | Pacific Psychology and Comprehensive Health Center | Community/Behavioral Health | 1411 Sw Morrison Ave, Suite 310, Portland, OR 97205 | 2015-10-16 |
| 1265803761 | Alana Branson | Naturopath | 1033 Sw Yamhill Street, Suite 403, Portland, OR 97205 | 2015-10-10 |
| 1720458011 | Kate Ohene | Counselor | 1411 Sw Morrison Street, Suite 310, Portland, OR 97205 | 2015-09-30 |
| 1285004671 | Christina Nannette Mendoza | Counselor | 1411 Sw Morriston Street, 310, Portland, OR 97205 | 2015-09-29 |
| 1083095947 | Patricia Burton | Registered Nurse | 1312 Sw Washinghton, Portland, OR 97205 | 2015-06-16 |
| 1649663071 | Huey Holistic | Clinic/Center | 1221 Sw Yamill, Suite 300, Portland, OR 97205 | 2015-03-10 |
| 1376952796 | Joan Kendall Ayala | Counselor | 610 Sw Alder St Ste 915, Portland, OR 97205 | 2014-08-11 |
| 1316356165 | Satheara Sin | Massage Therapist | 1033 Sw Yamhill St. #403, Portland, OR 97205 | 2014-08-06 |
| Find all providers in zip 97205 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881483 | True Diagnostics | Clinical Medical Laboratory | 1122 Ne 122nd Ave Ste B-102, Portland, OR 97230-2081 | 2020-08-14 |
| 1497363543 | Laboratory Corporation of America | Clinical Medical Laboratory | 4212 Ne Broadway Rm L100, Portland, OR 97213-1422 | 2020-07-15 |
| 1568927903 | Alerra, LLC | Clinical Medical Laboratory | 618 Nw 12th Ave Apt 412, Portland, OR 97209-3031 | 2019-02-08 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1346559168 | Metwest Inc | Clinical Medical Laboratory | 10535 Ne Glisan St Ste 100, Portland, OR 97220-4076 | 2010-09-28 |
| 1649428285 | Holter Labs | Clinical Medical Laboratory | 7327 Sw Barnes Rd, Portland, OR 97225-6119 | 2008-09-08 |
| 1861617680 | Kashi Clinical Laboratories Inc | Clinical Medical Laboratory | 10101 Sw Barbur Blvd. Suite 200, Portland, OR 97219-5915 | 2007-04-16 |
| 1740306935 | Nunm Laboratory | Clinical Medical Laboratory | 3025 Sw Corbett Street, Portland, OR 97201 | 2007-03-21 |
| 1154454718 | Portland Tissue Processing Laboratory, Inc. | Clinical Medical Laboratory | 5012 Ne 42nd Ave, Portland, OR 97218-1504 | 2007-03-13 |
| 1144399304 | Reproductive Medicine Laboratory | Clinical Medical Laboratory | 2222 Nw Lovejoy St Ste 304, Portland, OR 97210-5100 | 2006-11-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.