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NPI Code Detail

MEDICARE: THE OREGON CLINIC PC

MEDICARE: THE OREGON CLINIC PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0800XEndoscopy Clinic/Center07-1535OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073778346
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE OREGON CLINIC PC
Provider Business Mailing Address
First Line : 541 NE 20TH AVE STE 225
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2895
Country : US
Telephone Number : 503-963-2801
Fax Number : 503-963-2825
Provider Business Practice Location Address
First Line : 1111 NE 99TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97220-9428
Country : US
Telephone Number : 503-963-2801
Fax Number : 503-963-2825
Authorized Official
Title or Position : CEO PRESIDENT
Name : RICHARD L JAMISON
Credential : M.D.
Telephone Number : 503-963-2801
Provider Enumeration Date : 07/25/2008
Last Update Date : 12/03/2025

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1831182179 — JAMES KEVIN REGAN MD
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1033379862 — DR. AMY LI RONG ZHU MD
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1831156025 — SIDHARTH SHANKAR BHARDWAJ M.D.
Practice Location Address:
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PORTLAND, OR
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1649272451 — DR. KENT GEORGE BENNER MD
Practice Location Address:
1111 NE 99TH AVE , SUITE 301
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Practice Fax: 503-963-2802

Directions to “THE OREGON CLINIC PC ” Practice Location

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