NPIMap

Organization Active NPI

Pacific Crest Childrens Urgent Care LLC

  • Urgent Care Clinic/Center
  • Portland, OR
National Provider Identifier
1164947701
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PACIFIC CREST CHILDRENS URGENT CARE LLC
Practice address
6924 NE Sandy Blvd
Portland, OR 97213-5256
Phone
(503) 300-4111
Fax
(503) 954-2112
NPI assigned
Aug 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Dr. Corey Adair Fish, MDNPI 1871720136
Title
Chief Medical Officer
Phone
(503) 963-7963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

6924 NE Sandy Blvd
Portland, OR 97213-5256

Mailing address

6924 NE Sandy Blvd
Portland, OR 97213-5256
Phone (503) 300-4111

Other practice location 1

2935 SW Cedar Hills Blvd
Ste 100
Beaverton, OR 97005-1342
Phone (503) 300-4111

Other practice location 2

7215 SE Milwaukie Ave
Portland, OR 97202-6103
Phone (503) 300-4111

Other practice location 3

5915 La Crosse Avenue
Bldg 2, Ste 140
Austin, TX 78739-1783
Phone (503) 300-4111

Other names 1

  • Brave Care Doing business as

National Provider Directory

National Provider Directory

Locations

2935 SW Cedar Hills Blvd
Ste 100
Beaverton, OR 97005
Phone (503) 300-4111

6924 NE Sandy Blvd
Portland, OR 97213
Phone (503) 300-4111

5915 La Crosse Ave
Ste 140
Austin, TX 78739
Phone (503) 300-4111

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1164947701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135256",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135256",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2935 SW Cedar Hills Blvd",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970051342",
            "country_code": "US",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7215 SE Milwaukie Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972026103",
            "country_code": "US",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5915 La Crosse Avenue",
            "address_2": "Bldg 2, Ste 140",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787391783",
            "country_code": "US",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFIC CREST CHILDRENS URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "503-963-7963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brave Care",
            "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 May 30, 2023; 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.