LEGACY LABORATORY SERVICES, LLC (NPI# 1902059538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902059538 |
| Entity Type | Organization |
| Organization Name | LEGACY LABORATORY SERVICES, LLC |
| Practice Address |
1225 Ne 2nd Ave Portland OR 97232-2003 |
| Mailing Address |
Po Box 5337 Portland OR 97228-5337 |
| Practice Telephone | 5034135050 |
| Practice Fax Number | 5034133212 |
| Mailing Telephone | 5034134420 |
| Mailing Fax Number | 5034134405 |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2009-04-14 |
| Authorized Official Name | PAMELA S VUCKOVICH (SR VP AND CFO) |
| Authorized Official Telephone | 5034155730 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEGACY EMANUEL HOSPITAL AND HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 38D0625165 | OR | Laboratories |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEGACY LABORATORY SERVICES, LLC | 1225 Ne 2nd Ave, Portland, OR 97232-2003 |
| Oregon Corporations, Companies and Business Names | LEGACY LABORATORY SERVICES, LLC | 1225 Ne 2nd Avenue, Portland, OR 97232 |
| Street Address |
1225 NE 2ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497727903 | Gregory Miller | Psychiatry & Neurology | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2006-02-07 |
| 1104435809 | Caleb Terence Hughes | Counselor | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2020-07-28 |
| 1073078366 | Jeremy Michael Good | Registered Nurse | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2019-01-31 |
| 1053806653 | James Clark Trott | Registered Nurse | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2018-06-26 |
| 1912410630 | Valerie Spear | Nurse Practitioner | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2017-11-16 |
| 1376074427 | Angella Michelle King Cole | Registered Nurse | 1225 Ne 2nd Ave, Portland, OR 97232 | 2017-03-21 |
| 1245773225 | Legacy Emanuel Hospital & Health Center | Psychiatric Unit | 1225 Ne 2nd Ave, Portland, OR 97232-2003 | 2016-11-23 |
| 1003367491 | Legacy Emanuel Hospital & Health Center | General Acute Care Hospital | 1225 Ne 2nd Ave, Portland, OR 97232 | 2016-10-20 |
| 1083078265 | Corey Elizabeth Watson | Nurse Practitioner | 1225 Ne 2nd Ave, Portland, OR 97232 | 2016-04-13 |
| 1043692676 | Rodney Stuart Olin | Nurse Practitioner | 1225 Ne 2nd Ave, Unity Center, Portland, OR 97232-2003 | 2015-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| 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 |
| 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.