LEGACY HEALTH (NPI# 1720537111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720537111 |
| Entity Type | Organization |
| Organization Name | LEGACY HEALTH |
| Practice Address |
1040 Nw 22nd Ave Suite 110 Portland OR 97210-3057 |
| Practice Telephone | 5034136739 |
| Practice Fax Number | 5034136793 |
| Mailing Telephone | 5034136739 |
| Mailing Fax Number | 5034136793 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |
| Authorized Official Name | MIKE NEWCOMB (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 5034155252 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | MD23478 | OR | Hospitals |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LEGACY HEALTH | 1919 Nw Lovejoy St, Legal Services Department, Portland, OR 97209 |
| Washington State Corporations | LEGACY HEALTH | 1919 Nw Lovejoy St, Legal Services Dept., Portland, OR 97209-1503 |
| Oregon Corporations, Companies and Business Names | LEGACY HEALTH & FITNESS | 3823 Jones St, Newberg, OR 97132 |
| System for Award Management (SAM) Entities | LEGACY HEALTH CONNECTIONS | 3305 Stonebrook Cir Nw, Huntsville, AL 35810-3778 |
| Iowa Business Entities | LEGACY HEALTH CONSULTANTS LLC | 135 Ne 6th St, Earlham, IA 50072 |
| Oregon Corporations, Companies and Business Names | LEGACY HEALTH FOUNDATION | 1919 Nw Lovejoy Street, Legal Services Department, Portland, OR 97209 |
| Iowa Business Entities | LEGACY HEALTH LLC | 9187 Burkwood Dr, 104, West Des Moines, IA 50266 |
| System for Award Management (SAM) Entities | LEGACY HEALTH MANAGEMENT GROUP, LLC | 6501 Mechanicsville Tpke Ste G01, Mechanicsville, VA 23111-3698 |
| Oregon Corporations, Companies and Business Names | LEGACY HEALTH PARTNERS, LLC | 1919 Nw Lovejoy Street, Portland, OR 97209 |
| Oregon Corporations, Companies and Business Names | LEGACY HEALTH PLAN, INC. | 1919 Nw Lovejoy St, Portland, OR 97209 |
| Street Address |
1040 NW 22ND AVE SUITE 110 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717852 | Raylene Dianne Coleman | Nurse Practitioner | 1040 Nw 22nd Ave, Suite 420, Portland, OR 97210-3057 | 2005-08-11 |
| 1386204980 | Dorian Ariel Zeidenweber | Student in an Organized Health Care Education/Training Program | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2019-06-17 |
| 1982194429 | Katherine Crawford | Dietitian, Registered | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2018-05-10 |
| 1053779801 | Tasha Nicole Searles | Clinical Nurse Specialist | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3057 | 2016-02-08 |
| 1497120380 | Martha Rissmiller | Physical Therapist | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3057 | 2015-12-03 |
| 1427436971 | Claire Hanway | Nurse Practitioner | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3026 | 2015-05-15 |
| 1629401963 | Pui Yi Boey | Ophthalmology | 1040 Nw 22nd Ave, Suite #200, Portland, OR 97210-3057 | 2013-08-09 |
| 1366783631 | David Larson Demill | Ophthalmology | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2013-03-11 |
| 1639414410 | Dewi Kae De Jarnett | Nurse Anesthetist, Certified Registered | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2012-12-04 |
| 1467709576 | Julia C. Talajic | Ophthalmology | 1040 Nw 22nd Ave, Suite 200, Portland, OR 97210-3057 | 2012-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| 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 |
| 1093132946 | Mercy Hospital | General Acute Care Hospital | 175 Fore River Pkwy, Portland, ME 04102-2779 | 2014-03-27 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 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 |
| 1205024387 | Vetrans Administration | General Acute Care Hospital | 6215 Ne Broadway St, Portland, OR 97213-4713 | 2007-10-14 |
| 1235337551 | Kalei Renae Kadau | General Acute Care Hospital | 1717 Sw Park Ave Apt 813, Portland, OR 97201-3240 | 2007-07-08 |
| 1134242506 | Portland Veterans Affairs Medical Center | General Acute Care Hospital | 5430 Sw Cameron Rd, Portland, OR 97221 | 2007-04-09 |
| 1487788147 | Portland Va Medical Center | General Acute Care Hospital | 5404 Sw Vermont St, Portland, OR 97219-1034 | 2007-03-15 |
| 1457436248 | Kathleen M Hamel | General Acute Care Hospital | 3710 Se Us Veterans Hospital Rd, Portland, OR 97207-9823 | 2006-10-27 |
| Find all providers in PORTLAND | ||||
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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.