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General NPI Number Information
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NPI Number | 1194568469
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Entity Type | Organization
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Legal Business Name | OHSU OUTPATIENT CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1800 NE 2ND AVE
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City | PORTLAND
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State | OR
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Zip | 97212-3932
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Country | US
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Telephone | 503-346-4949
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 SW 5TH AVE FL 5
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City | PORTLAND
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State | OR
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Zip | 97201-5509
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Country | US
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Telephone | 503-494-1414
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Fax |
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Authorized Official
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Title or Position | VP, CONTROLLER
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Name | SANDRA CATALAN
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Credential |
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Telephone | 34-943-1015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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