NPIMap

Organization Active NPI

Portland Vamc

  • VA Clinic/Center
  • The Dalles, OR
National Provider Identifier
1104233295
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
PORTLAND VAMC
Practice address
704 Veterans Drive
The Dalles, OR 97058-9998
Phone
(702) 341-3164
NPI assigned
Jul 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Authorized official

Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

704 Veterans Drive
The Dalles, OR 97058-9998

Mailing address

PO Box 94414
Cleveland, OH 44101-4414
Phone (702) 341-3164

Other names 1

  • THE DALLES VA CLINIC Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2018183The Dalles VA Outreach Clinic704 Veterans Drive, The Dalles, OR 97058AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Portland Vamc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

704 Veterans Dr
The Dalles, OR 97058
Phone (541) 296-3937

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1104233295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94414",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014414",
            "telephone_number": "702-341-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 VETERANS DRIVE",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589998",
            "telephone_number": "702-341-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DALLES VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.