Gresham Station Surgery Center Llc

LBN: Gresham Station Surgery Center Llc
Gresham Station Surgery Center Llc is an health care organization with primary practice located at 831 Nw Council Drive Suite 212, Gresham OR 97030. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Gresham Station Surgery Center Llc can be contacted via phone (503) 907-1907, or through Skinner, Michael Ray via phone (503) 907-1907.

Contact Information

Primary practice address
831 Nw Council Drive Suite 212 Gresham OR 97030
Fax: (503) 489-2073
Website:
Authorized official contact:
Name: Skinner, Michael Ray Registered Nurse (RN)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 394819 Oregon
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 07-1567 Oregon

Profile Details

NPI number 1235195447
LBN Legal business name Gresham Station Surgery Center Llc
DBA Doing business as
Authorized official Skinner, Michael Ray Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2006
Last updated May 4th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235195447 NPPES
Oregon MEDICAID 213664

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