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General NPI Number Information
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NPI Number | 1568865921
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC & SPORTS MEDICINE CENTER OF OR LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 5050 NE HOYT ST SUITE 668
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City | PORTLAND
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State | OR
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Zip | 97213-2991
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Country | US
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Telephone | 503-224-8399
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Fax | 503-224-5661
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Provider Business Mailing Address
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Address Line | 17355 LOWER BOONES FERRY RD SUITE 100A
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City | LAKE OSWEGO
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State | OR
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Zip | 97035
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Country | US
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Telephone | 503-224-8399
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Fax | 503-224-5661
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Authorized Official
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Title or Position | AUTH OFFICIAL
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Name | KATHY S BROWN
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Credential |
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Telephone | 503-542-4849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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