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General NPI Number Information
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NPI Number | 1265417174
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Entity Type | Organization
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Legal Business Name | THE OREGON CLINIC PC
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 541 NE 20TH AVE SUITE 225
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City | PORTLAND
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State | OR
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Zip | 97232
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Country | US
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Telephone | 503-963-2801
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Fax | 503-963-2825
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Provider Business Mailing Address
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Address Line | PO BOX 5277
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City | PORTLAND
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State | OR
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Zip | 97208-5277
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Country | US
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Telephone | 503-963-2801
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Fax | 503-963-2825
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD JAMISON
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Credential |
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Telephone | 503-963-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 160412
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 160412
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 160412
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 160412
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 160412
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License Number State | OR
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