PORTLAND VAMC (NPI# 1104233295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104233295 |
| Entity Type | Organization |
| Organization Name | PORTLAND VAMC |
| Other Organization Name | THE DALLES VA CLINIC |
| Practice Address |
704 Veterans Drive The Dalles OR 97058-9998 |
| Mailing Address |
Po Box 94414 Cleveland OH 44101-4414 |
| Practice Telephone | 7023413164 |
| Mailing Telephone | 7023413164 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2017-11-01 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| THE DALLES VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346657491 | Portland Vamc | Clinic/Center | 308 Sw 1st Ave, Suite 155, Portland, OR 97204-3400 | 2014-07-21 |
| 1114151248 | Portland Vamc | Clinic/Center | 1925 Ne Stucki Ave Ste 300, Hillsboro, OR 97006-6945 | 2009-05-04 |
| 1710174974 | Portland Vamc | Clinic/Center | 1800 Ne Market Drive, Fairview, OR 97024-9998 | 2007-10-01 |
| 1720022940 | Portland Vamc | Clinic/Center | 91400 S Neacoxie Blvd, Building 7315, Warrenton, OR 97146-7267 | 2006-06-16 |
| 1376581371 | Portland Vamc | Clinic/Center | 1750 Mcgilchrist St Se, Suite 130, Salem, OR 97302-1691 | 2006-06-02 |
| 1184675803 | Portland Vamc | Clinic/Center | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2006-05-15 |
| 1639722275 | Portland Vamc | Clinic/Center | 4422 Ne Devils Lake Blvd Ste 2, Lincoln City, OR 97367-5000 | 2019-07-23 |
| 1497162556 | Portland Vamc | Clinic/Center | 1010 Sw Coast Hwy, Newport, OR 97365-5288 | 2014-07-21 |
| 1982957510 | Portland Vamc | Clinic/Center | 1750 Blankenship Rd, Suite 300, West Linn, OR 97068-5101 | 2012-10-19 |
| 1255424685 | Portland Vamc | Department of Veterans Affairs (VA) Pharmacy | 1601 E 4th Plain Blvd, Vancouver, WA 98661-3713 | 2006-09-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PORTLAND VAMC | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97207-2964 |
| Street Address |
704 VETERANS DRIVE |
| City | THE DALLES |
| State | OR |
| Zip Code | 97058-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646864 | Ashlee Kai Mcnamara | Behavior Technician | 2525 W 8th St., #34, The Dalles, OR 97058 | 2018-07-19 |
| 1548784689 | Mireya Moreno Ibarra | Behavior Technician | 401 East 3rd Street, Suite 101, The Dalles, OR 97058 | 2017-07-31 |
| 1407304991 | Joshua Seidel | Pharmacist | 515 Mt Hood St, The Dalles, OR 97058 | 2016-09-14 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1558731141 | Louise Goodnight | Case Manager/Care Coordinator | 419 East 7 Th Street, The Dalles, OR 97058 | 2015-09-25 |
| 1578944666 | Jessica Donnell | Dental Hygienist | 2529 E 12th St, The Dalles, OR 97058 | 2015-06-15 |
| 1487034328 | Savanna Schaan | Specialist | 609 W 14th St, The Dalles, OR 97058 | 2015-06-05 |
| 1801299102 | Mary E Zenorini | Social Worker | 1620 E. 12th St, The Dalles, OR 97058 | 2014-09-30 |
| 1669889143 | Diane Joan Irwin | Social Worker | 419 E 7th St #207, The Dalles, OR 97058 | 2014-07-17 |
| 1124452008 | Lacey A Nichols | Counselor | 312 E. Third St., The Dalles, OR 97058 | 2013-08-27 |
| Find all providers in zip 97058 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841714607 | Roseburg Vamc | Clinic/Center | 211 E 7th Ave Ste 220, Eugene, OR 97401-2722 | 2017-08-02 |
| 1457742538 | Walla Walla Vamc | Clinic/Center | 2 Marine Drive, Suite 103, Boardman, OR 97818-9998 | 2015-02-11 |
| 1710378898 | Walla Walla Vamc | Clinic/Center | 401 Northeast 1st Street, Suite A, Enterprise, OR 97828-1186 | 2015-02-11 |
| 1346657491 | Portland Vamc | Clinic/Center | 308 Sw 1st Ave, Suite 155, Portland, OR 97204-3400 | 2014-07-21 |
| 1548677602 | Boise Vamc | Clinic/Center | 635 Highway 20 N Ste 4, Hines, OR 97738-9462 | 2014-07-21 |
| 1790038339 | White City Vamc | Clinic/Center | 1877 Williams Highway, Grants Pass, OR 97527 | 2012-10-19 |
| 1114151248 | Portland Vamc | Clinic/Center | 1925 Ne Stucki Ave Ste 300, Hillsboro, OR 97006-6945 | 2009-05-04 |
| 1184812943 | Walla Walla Vamc | Clinic/Center | 202 12th St, La Grande, OR 97850-2879 | 2007-10-05 |
| 1710174974 | Portland Vamc | Clinic/Center | 1800 Ne Market Drive, Fairview, OR 97024-9998 | 2007-10-01 |
| 1720022940 | Portland Vamc | Clinic/Center | 91400 S Neacoxie Blvd, Building 7315, Warrenton, OR 97146-7267 | 2006-06-16 |
| Find all providers with the same taxonomy | ||||
| City | THE DALLES |
| Zip Code | 97058 |
Please comment or provide details below to improve the information on PORTLAND VAMC.
| 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.