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NPI Code Detail

MEDICARE: OREGON CLINIC, PC

MEDICARE: OREGON CLINIC, PC
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
1261QE0800XEndoscopy Clinic/Center394719OR

Other Identifiers

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

General Provider Information

NPI Number : 1831167253
Entity Type Code : Organization
Provider Name (Legal Business Name) : OREGON CLINIC, PC
Provider Business Mailing Address
First Line : 541 NE 20TH AVE STE 225
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2895
Country : US
Telephone Number : 503-963-2801
Fax Number : 503-963-2825
Provider Business Practice Location Address
First Line : 19250 SW 90TH AVE
Second Line :
City : TUALATIN
State : OR
Zip : 97062-7585
Country : US
Telephone Number : 503-692-3750
Fax Number : 503-691-2324
Authorized Official
Title or Position : CEO/PRESIDENT
Name : RICHARD L JAMISON
Credential : MD
Telephone Number : 503-963-2801
Provider Enumeration Date : 03/10/2006
Last Update Date : 12/03/2025

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Directions to “OREGON CLINIC, PC ” Practice Location

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