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General NPI Number Information
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NPI Number | 1801254644
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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 | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 546 NE 12TH AVE ROOM 126
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City | PORTLAND
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State | OR
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Zip | 97232-2719
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Country | US
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Telephone | 503-494-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 3930 SE DIVISION ST
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City | PORTLAND
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State | OR
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Zip | 97202-1643
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Country | US
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Telephone | 503-418-3900
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Fax | 503-418-3938
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Authorized Official
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Title or Position | INTERIM SR VP, EXECUTIVE DIRECTOR
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Name | CYNTHIA GRUEBER
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Credential |
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Telephone | 503-494-1450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health 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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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