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NPI Code Detail

MEDICARE: LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER

MEDICARE: LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
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
13336C0003XCommunity/Retail PharmacyRP-0001427-CSOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13806051OTHERORNCPDP

General Provider Information

NPI Number : 1609896174
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
Provider Business Mailing Address
First Line : 1040 NW 22ND AVE
Second Line : SUITE 100
City : PORTLAND
State : OR
Zip : 97210
Country : US
Telephone Number : 503-413-4048
Fax Number : 503-413-4449
Provider Business Practice Location Address
First Line : 1040 NW 22ND AVE
Second Line : SUITE 100
City : PORTLAND
State : OR
Zip : 97210-3057
Country : US
Telephone Number : 503-413-8122
Fax Number :
Authorized Official
Title or Position : VP FINANCE
Name : SARAH JENSEN
Credential :
Telephone Number : 503-415-5145
Provider Enumeration Date : 07/20/2006
Last Update Date : 01/20/2026

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1891787396 — DENNIS HONG MD
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1407848831 — LESLIE DAVIS MCALLISTER MD
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1598758534 — REED CALHOUN WILSON MD
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Directions to “LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER ” Practice Location

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