NPIMap

Organization Active NPI

Providence St Vincent Medical Center

Doing business as Providence Integrative Medicine West

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1033345012
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PROVIDENCE ST VINCENT MEDICAL CENTER
Doing business as
Providence Integrative Medicine West
Practice address
9135 SW Barnes Rd
Suite 161
Portland, OR 97225-6601
Phone
(503) 216-0246
NPI assigned
Jun 4, 2009
Organization subpart
Yes
Parent organization
PROVIDENCE ST VINCENT MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dennis Noonan
Title
Chief Finance Officer
Phone
(503) 216-4657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

9135 SW Barnes Rd
Suite 161
Portland, OR 97225-6601

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other names 1

  • PROVIDENCE INTEGRATIVE MEDICINE WEST Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Vincent HSP and Med9 organizations share this tax ID, including this one
Part of
St Vincent HSP and Med

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9135 SW Barnes Rd
Ste 161
Portland, OR 97225
Phone (503) 991-9976

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1033345012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD",
            "address_2": "SUITE 161",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256601",
            "telephone_number": "503-216-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ST VINCENT MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE ST VINCENT MEDICAL CENTER",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CHIEF FINANCE OFFICER",
        "authorized_official_telephone_number": "503-216-4657"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE INTEGRATIVE MEDICINE WEST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.