NPIMap

Organization Active NPI

Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
National Provider Identifier
1255354700
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
14-1337 Issued in OR
Legal business name
LEGACY MOUNT HOOD MEDICAL CENTER
Practice address
24800 SE Stark St
Gresham, OR 97030-3378
Phone
(503) 674-1122
NPI assigned
Jul 25, 2006
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Sarah Jensen
Title
VP Finance
Phone
(503) 415-5145

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 141337 OR
General Acute Care Hospital 282N00000X 14-1337 OR Primary

Addresses

Primary practice location

24800 SE Stark St
Gresham, OR 97030-3378

Mailing address

PO Box 4037
Portland, OR 97208-4037
Phone (503) 413-4048

Other identifiers 1

IdentifierTypeStateIssuer
069526MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040401000550 OR Part B Supplier - Clinic/Group Practice 3173515996 Receives reassigned benefits from 141 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gresham, OR; Portland, OR
O20050706001081 OR Part A Provider - Hospital 3173515996 Practice locations: Gresham, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255354700. Details of each certification follow.

Hospital certification: CCN 380025

Legal name
LEGACY MOUNT HOOD MEDICAL CENTER
Doing business as
LEGACY MOUNT HOOD MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 14, 1971
Last certification
Jun 11, 2004
Beds
115
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Jan 18, 1984 in OR
Enrollment address
24800 SE Stark St
Gresham, OR 97030-3378
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Legacy Mount Hood Medical CenterCCN 380025 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Legacy Mount Hood Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

24900 SE Stark St
Ste 106
Gresham, OR 97030
Phone (503) 413-3879

24900 SE Stark St
Ste 109
Gresham, OR 97030
Phone (503) 667-1015

25050 SE Stark St
Ste 100
Gresham, OR 97030
Phone (503) 674-1122

25050 SE Stark St
Ste 14001
Gresham, OR 97030
Phone (503) 674-1122

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph H Frankhouse Individual Corporate DirectorBoard Member Jun 1, 2023
Jack Friedman Individual Corporate DirectorBoard Member Jun 1, 2018
Edgar Navas Individual Corporate DirectorBoard Member Jun 1, 2020
Richard P Reiten Individual Corporate DirectorBoard Member Jul 25, 2013
Jerry Petty Individual Corporate DirectorBoard Member Jun 1, 2018
Charles Wilhoite Individual Corporate DirectorChair Jun 1, 2017
Nancy Locke Individual Corporate DirectorBoard Member Jun 1, 2016
Leslie Root Individual Corporate DirectorBoard Member Jul 25, 2013
Jeffrey Barber Individual Corporate DirectorBoard Member Jul 25, 2013
Legacy Health Organization, Portland, OR Operational/Managerial Control Nov 19, 2007
Nancy Horton Individual Corporate DirectorBoard Member Jun 1, 2019
Craig Armstrong Individual Corporate DirectorSecretary Sep 1, 2023
Teresa L Handy Individual W-2 Managing EmployeeVP Revenue Cycle Mar 2, 2012
Lynn T Gust Individual Corporate DirectorBoard Member Jun 1, 2017
George Joseph Brown Individual Corporate OfficerBoard President Jun 10, 2024
Gayle Goschie Individual Corporate DirectorBoard Member Jun 1, 2016
Lisa Freedman Individual Corporate DirectorBoard Member Jun 1, 2019
Nathalie Johnson Individual Corporate DirectorBoard Member Jun 1, 2023
Nasreen a Ilias-Khan Individual Corporate DirectorBoard Member May 15, 2021
David Ramus Individual Corporate DirectorVice Chair Jan 1, 2015
Samir B Desai Individual Corporate DirectorBoard Member Jun 1, 2017
Sarah Jensen Individual Corporate OfficerVP, Finance May 18, 2017
W-2 Managing EmployeeVP, Finance Oct 1, 2015
Carolyn Coggins Individual Corporate DirectorTreasurer Sep 22, 2025

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 162

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 162

Affiliated clinicians 459

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 459

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1255354700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4037",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084037",
            "telephone_number": "503-413-4048",
            "fax_number": "503-413-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MOUNT HOOD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "503-415-5145"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "141337",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OR",
            "license": "14-1337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069526",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.