Healthcare Provider Details

I. General information

NPI: 1609824010
Provider Name (Legal Business Name): OREGON HEALTH & SCIENCE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

2525 SW 3RD AVE STE 245
PORTLAND OR
97201-4901
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8744
  • Fax:
Mailing address:
  • Phone: 503-494-8548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number141008
License Number StateOR

VIII. Authorized Official

Name: MS. JENNIFER L. DOLL
Title or Position: SR VICE PRESIDENT/CFO
Credential:
Phone: 503-494-8548