LEGACY MERIDIAN PARK HOSPITAL (NPI# 1184647620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184647620 |
| Entity Type | Organization |
| Organization Name | LEGACY MERIDIAN PARK HOSPITAL |
| Practice Address |
19300 Sw 65th Ave Tualatin OR 97062-7706 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5036921212 |
| Mailing Telephone | 5034132017 |
| Mailing Fax Number | 5034133212 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | SARAH JENSEN (INTERIM CFO) |
| Authorized Official Telephone | 5034155145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| Y | 282N00000X | General Acute Care Hospital | 14-1336 | OR | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | XHSP30260 | 05 | |
| OR | 122499 | 05 | |
| CA | XHSP40260 | 05 | |
| OR | REGENCE BLUE CROSS | 138008900 | 01 |
| WA | 3018504 | 05 | |
| AK | HS691OP | 05 | |
| AK | HS691IP | 05 | |
| OR | 234454 | 05 | |
| ID | 33766 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023305034 | Legacy Meridian Park Hospital | Hospitalist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2011-06-29 |
| 1689694150 | Legacy Meridian Park Hospital | Pharmacy | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2006-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LEGACY MERIDIAN PARK HOSPITAL | 19300 Sw 65th, Tualatin, OR 97062 |
| Street Address |
19300 SW 65TH AVE |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-7706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417392 | Paul R Ash | Psychiatry & Neurology | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2005-06-14 |
| 1689217044 | Jacob White | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-17 |
| 1679114011 | Jeri Leanne Shanahan | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-07 |
| 1255840161 | Cinthia Marie Adair | Speech-Language Pathologist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2017-09-22 |
| 1609311059 | Olivia Terris | Dietitian, Registered | 19300 Sw 65th Ave, Cardiac and Pulmonary Rehab, Tualatin, OR 97062-7706 | 2016-12-21 |
| 1568826386 | Kathryn Renee Foutch | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2016-04-07 |
| 1497129035 | Job Anderson | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2015-11-19 |
| 1750775698 | Jessica Lorenz | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062 | 2015-03-27 |
| 1528487956 | Raelin Fullmer I | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062 | 2014-04-14 |
| 1497170849 | Legacy Meridan Park Hospital | Pharmacy | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2014-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447665526 | Linda Damaskos | General Acute Care Hospital | 310 Nw Upyown Terrace, 2a, Portland, OR 97210 | 2014-06-26 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1235483199 | Kaiser Sunnyside Medical Center | General Acute Care Hospital | 3480 Mock Orange Ct S, Salem, OR 97302-3647 | 2012-10-30 |
| 1891048807 | Kaiser Foundation Hospitals | General Acute Care Hospital | 2875 Nw Stucki Ave., Hillsboro, OR 97124-5806 | 2012-10-16 |
| 1710241922 | Silverton Hospital | General Acute Care Hospital | 700 Sw Lupine Ct, Sublimity, OR 97385-9509 | 2012-07-02 |
| 1215213756 | Northwest Association of Surgical Assistants, Inc. | General Acute Care Hospital | 3782 Po Box, Springfield, OR 97475 | 2011-10-28 |
| 1194024760 | Lisa Marie Arbuckle | General Acute Care Hospital | 16105 Sw 108th Ave, Apt. 212, Tigard, OR 97224-4870 | 2011-03-22 |
| 1679879662 | Veterans Hospital | General Acute Care Hospital | 3710 S.w. U.S. Veterans Road, Portland, OR 97239-2964 | 2011-02-08 |
| 1083866933 | Providence St Vincent Hospital | General Acute Care Hospital | 1235 Ne 47th Ave, Suite 285, Portland, OR 97213-2100 | 2008-10-22 |
| Find all providers with the same taxonomy | ||||
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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.