Healthcare Provider Details

I. General information

NPI: 1003822487
Provider Name (Legal Business Name): LEGACY EMANUEL HOSPITAL & HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 NE 2ND AVE
PORTLAND OR
97232-2003
US

IV. Provider business mailing address

PO BOX 4037
PORTLAND OR
97208-4037
US

V. Phone/Fax

Practice location:
  • Phone: 503-944-8000
  • Fax:
Mailing address:
  • Phone: 503-413-4048
  • Fax: 503-413-4449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number14-0056
License Number StateOR

VIII. Authorized Official

Name: SARAH JENSEN
Title or Position: VP FINANCE
Credential:
Phone: 503-415-5145