| Oregon Health & Science University | |
| 
					10101 Se Main St Ste 1001 Portland OR 97216-2456  | |
| (503) 346-6400 | |
| (503) 346-6330 | 
| Full Name | Oregon Health & Science University | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 10101 Se Main St Ste 1001, Portland, Oregon | 
| Authorized Official Name and Position | Jennifer L Doll (SR. VP) | 
| Authorized Official Contact | 5033074870 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Oregon Health & Science University 3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 Ph: (503) 494-8311  | Oregon Health & Science University 10101 Se Main St Ste 1001 Portland OR 97216-2456 Ph: (503) 346-6400  | 
| NPI Number | 1245093533 | 
|---|---|
| Provider Enumeration Date | 01/31/2024 | 
| Last Update Date | 04/18/2024 | 
| Medicare PECOS PAC ID | 1759328842 | 
|---|---|
| Medicare Enrollment ID | O20240610001025 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245093533 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary | 
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