Healthcare Provider Details

I. General information

NPI: 1285568949
Provider Name (Legal Business Name): LIN HEALTH MEDICAL GROUP OF OREGON, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW BETHANY BLVD STE 200
BEAVERTON OR
97006-5236
US

IV. Provider business mailing address

3513 BRIGHTON BLVD STE 457
DENVER CO
80216-3810
US

V. Phone/Fax

Practice location:
  • Phone: 888-691-5818
  • Fax: 877-391-0882
Mailing address:
  • Phone: 888-691-5818
  • Fax: 877-391-0882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSIE DALTON
Title or Position: DIRECTOR, REVENUE & OPERATIONS
Credential:
Phone: 720-782-1046