MEDICARE: OREGON HEALTH & SCIENCE UNIVERSITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417969304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OREGON HEALTH & SCIENCE UNIVERSITY

Provider Business Mailing Address
First Line	:	1400 SW 5TH AVE FL 5
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-5509
Country	:	US
Telephone Number	:	877-943-2507
Fax Number	:	503-494-4455

Provider Business Practice Location Address
First Line	:	51377 SW OLD PORTLAND RD
Second Line	:
City	:	SCAPPOOSE
State	:	OR
Zip	:	97056-4023
Country	:	US
Telephone Number	:	503-418-4222
Fax Number	:	503-418-4223

Authorized Official
Title or Position	:	VP/ENTERPRISE REVENUE CYCLE
Name	:	KELLY ANNE SMITH
Credential	:
Telephone Number	:	503-494-4422

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	09/12/2025

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Directions to “OREGON HEALTH & SCIENCE UNIVERSITY ” Practice Location

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