Providence Neurological Specialties Ppmc

LBN: Providence Health & Services - Oregon
Providence Neurological Specialties Ppmc is an health care organization with primary practice located at 4805 Ne Glisan St Suite 6N50, Portland OR 97213-2933. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Ambulatory Health Care Facilities / Clinic/Center, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 216-1150, or through Freeman, Keenan B via phone (503) 593-6524.

Contact Information

Primary practice address
4805 Ne Glisan St Suite 6N50 Portland OR 97213-2933
Phone: (503) 216-1150
Fax: (503) 216-1066
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan B
Phone: (503) 593-6524

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1336311554
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence Neurological Specialties Ppmc
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Mar 27th, 2008
Last updated Sep 10th, 2012 - about 14 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 1336311554 NPPES
Oregon MEDICAID 279129

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