MEDICARE: PORTLAND ADVENTIST MEDICAL CENTER

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
1	251E00000X	Home Health Agency	14 1127	OR

General Provider Information

NPI Number	:	1396727848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTLAND ADVENTIST MEDICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 16800
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97292-0800
Country	:	US
Telephone Number	:	503-257-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5835 NE 122ND AVE
Second Line	:	BUILDING A; SUITE #155
City	:	PORTLAND
State	:	OR
Zip	:	97230-1057
Country	:	US
Telephone Number	:	503-251-6301
Fax Number	:	503-251-6265

Authorized Official
Title or Position	:	CEO
Name	:	JOYCE L NEWMYER
Credential	:
Telephone Number	:	503-257-2500

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	08/21/2014

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Directions to “PORTLAND ADVENTIST MEDICAL CENTER ” Practice Location

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