Odyssey Science Innovations, LLC

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

ODYSSEY SCIENCE INNOVATIONS, LLC

Practice address

6 Centerpointe Dr Ste 450
Lake Oswego, OR 97035-8621

Phone

(503) 489-8929

NPI assigned

Mar 25, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Alex Goldberg

Title

Ceo

Phone

(503) 577-7571

Specialties & licenses 1

Addresses

Other names 1

• Provata Health Doing business as

Tax ID family

Odyssey Science Innovations2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Odyssey Science Innovations

  • Public Health or Welfare Agency
  • Portland, OR
  • NPI 1144668583
  NPD tax ID

Locations

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1255793519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CENTERPOINTE DR STE 450",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358621",
            "telephone_number": "503-489-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CENTERPOINTE DR STE 450",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358621",
            "telephone_number": "503-489-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY SCIENCE INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-577-7571",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provata Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Oakridge Medical Clinic
• OB GYN Breast Imaging PC
• Occupational Health Centers of the Southwest P.a.
• Shannon Odell, PSYD
• Odyssey Healthcare Operating a LP
• Ofp LLC
• Tanell E. Ogbeide, C.F.N.P.
• Michelle Ogden, LMT
• Jeb S Oliver, MSW
• Stephen J Olsen, O.D.

• Health Educator in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Health Educator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.