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General NPI Number Information
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NPI Number | 1003278920
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Entity Type | Organization
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Legal Business Name | OREGON HEALTH & SCIENCE UNIVERSITY
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 700 NE 87TH AVE SUITE 110
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City | VANCOUVER
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State | WA
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Zip | 98664-1913
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Country | US
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Telephone | 360-882-2778
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Fax | 360-604-1720
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-8411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH (JOE) ROBERTSON
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Credential | M.D.
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Telephone | 503-494-7861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 14-1008
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License Number State | OR
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