Healthcare Provider Details

I. General information

NPI: 1831167253
Provider Name (Legal Business Name): OREGON CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19250 SW 90TH AVE
TUALATIN OR
97062-7585
US

IV. Provider business mailing address

541 NE 20TH AVE STE 225
PORTLAND OR
97232-2895
US

V. Phone/Fax

Practice location:
  • Phone: 503-692-3750
  • Fax: 503-691-2324
Mailing address:
  • Phone: 503-963-2801
  • Fax: 503-963-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number394719
License Number StateOR

VIII. Authorized Official

Name: RICHARD L JAMISON
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 503-963-2801