NPIMap

Organization Active NPI

Bembenek Travel Health Or

Doing business as Passport Health

  • Community Health Worker
  • Beaverton, OR
National Provider Identifier
1205534328
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
BEMBENEK TRAVEL HEALTH OR
Doing business as
Passport Health
Practice address
3720 SW 141St Ave
Suite 202
Beaverton, OR 97005
Phone
(844) 358-8648
Fax
(877) 877-6875
NPI assigned
Feb 17, 2023
Last updated
Feb 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Mr. Paul Fishburn
Title
Coo
Phone
(480) 646-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

3720 SW 141St Ave
Suite 202
Beaverton, OR 97005

Mailing address

4343 East Outlier BLV.
Phoenix, AZ 85008-6507
Phone (844) 358-8648

Other names 1

  • Passport Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bembenek Travel Health Wa4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3720 SW 141st Ave
Ste 202
Beaverton, OR 97005
Phone (503) 715-0910

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1205534328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 EAST OUTLIER BLV.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "844-358-8648",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 SW 141ST AVE",
            "address_2": "SUITE 202",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97005",
            "telephone_number": "844-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEMBENEK TRAVEL HEALTH OR",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "FISHBURN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-646-9020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.