Greater Portland Neurosurgical Center, PC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD11164 Issued in OR

Legal business name

GREATER PORTLAND NEUROSURGICAL CENTER, PC

Practice address

24900 SE Stark St Ste 209
Gresham, OR 97030-3382

Phone

(503) 665-5522

Fax

(503) 665-8822

NPI assigned

Mar 26, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Julio Ordonez, MD

Title

Owner

Phone

(503) 665-5522

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1033451265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24900 SE STARK ST STE 209",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303382",
            "telephone_number": "503-665-5522",
            "fax_number": "503-665-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24900 SE STARK ST STE 209",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303382",
            "telephone_number": "503-665-5522",
            "fax_number": "503-665-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PORTLAND NEUROSURGICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "ORDONEZ",
        "authorized_official_first_name": "JULIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-665-5522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD11164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "R169208",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192138",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Howard Lee Grattan, MD
• Denise Grave
• Alexandra Lynn Gray, PA
• Greater New Hope Charities
• Greater New Hope Family Services
• Todd Eric Greblo, M.S. CCC-CFY
• Mimi Greco
• Dana Green
• Jamey Green, RDH, EPDH
• Shantika Green, LCSW

• Neurological Surgery Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Neurological Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.