PORTLAND VAMC (NPI# 1346657491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346657491 |
| Entity Type | Organization |
| Organization Name | PORTLAND VAMC |
| Other Organization Name | PORTLAND 1 VA CLINIC |
| Practice Address |
308 Sw 1st Ave Suite 155 Portland OR 97204-3400 |
| 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 |
|---|---|
| PORTLAND 1 VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104233295 | Portland Vamc | Clinic/Center | 704 Veterans Drive, The Dalles, OR 97058-9998 | 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 |
308 SW 1ST AVE SUITE 155 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97204-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447719992 | Jarvis Craig Allen | Social Worker | 308 Sw 1st Ave, Portland, OR 97204-3400 | 2019-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922662352 | Sleep Management, L.L.C. | Respiratory Therapist, Registered | 1050 Sw 6th Avenue, Suite 1100 Office # 52, Portland, OR 97204 | 2019-05-01 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1790133031 | Modupe Desiree Bansile | Counselor | 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 | 2016-05-26 |
| 1841655834 | Isabella Zaragoza | Counselor | 421 Sw Oak St Suite 520, Portland, OR 97204 | 2015-12-18 |
| 1952737736 | Hessler-cohen Enterprises LLC | Acupuncturist | 310 Sw 4rth Avenue, Suite 725, Portland, OR 97204 | 2013-09-24 |
| 1144583378 | Angela Nicole Johnson | Physical Therapist | 555 Sw Oak Street, Portland, OR 97204 | 2012-06-22 |
| 1255614624 | Jaclyn Rene Jones | Nurse Practitioner | 601 Sw 4th Ave, Portland, OR 97204 | 2011-09-22 |
| 1407148398 | Cristianne Paulsen | Dental Hygienist | 426 Sw Stark, 9th Floor, Portland, OR 97204 | 2011-05-10 |
| 1396928255 | Jessica L Hall | Counselor | 421 Sw Oak Street, Suite 520, Portland, OR 97204 | 2007-12-13 |
| 1699896274 | Julie Anne Oyemaja | Counselor | 421 Sw Oak St., Ste. 210, Portland, OR 97204 | 2007-04-02 |
| Find all providers in zip 97204 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114961992 | Togus Vamc | Clinic/Center | 144 Fore St, Suite 200, Portland, ME 04101-4843 | 2006-06-15 |
| 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 |
| 1104233295 | Portland Vamc | Clinic/Center | 704 Veterans Drive, The Dalles, OR 97058-9998 | 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 | ||||
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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.