Healthcare Provider Details

I. General information

NPI: 1710943303
Provider Name (Legal Business Name): VIKAS GROVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2282 NW NORTHRUP ST RM 41 SUITE 400
PORTLAND OR
97210-2919
US

IV. Provider business mailing address

3377M RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-5542
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA116731
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA116731
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number73190
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD158445
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: