Healthcare Provider Details

I. General information

NPI: 1023261286
Provider Name (Legal Business Name): NORTHWEST PERMANENTE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NE MULTNOMAH ST SUITE 100
PORTLAND OR
97232-2023
US

IV. Provider business mailing address

500 NE MULTNOMAH ST SUITE 100
PORTLAND OR
97232-2023
US

V. Phone/Fax

Practice location:
  • Phone: 503-813-3860
  • Fax: 503-813-3889
Mailing address:
  • Phone: 503-813-3860
  • Fax: 503-813-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT STRATTON
Title or Position: DIRECTOR, ERM AND SENIOR COUNSEL
Credential: JD
Phone: 971-990-9172