Providence St Vincent Heart Clinics Cardiology Bridgeport

LBN: Providence Health & Services - Oregon
Providence St Vincent Heart Clinics Cardiology Bridgeport is an health care organization with primary practice located at 18040 Sw Lower Boones Ferry Rd Suite 204, Tigard OR 97224-7259. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 216-6060, or through Freeman, Keenan B via phone (503) 893-6524.

Contact Information

Primary practice address
18040 Sw Lower Boones Ferry Rd Suite 204 Tigard OR 97224-7259
Fax: (503) 216-6040
Website:
Authorized official contact:
Name: Freeman, Keenan B

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1588981963
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Providence St Vincent Heart Clinics Cardiology Bridgeport
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Apr 26th, 2010
Last updated Jun 2nd, 2014 - about 12 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 1588981963 NPPES
Oregon MEDICAID 500622006

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