Rose City Health Clinic LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

1917 Issued in OR

Legal business name

ROSE CITY HEALTH CLINIC LLC

Practice address

5308 SE Rhone St
Portland, OR 97206-2962

Phone

(503) 960-2162

Fax

(503) 967-7069

NPI assigned

Sep 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Angela D Cortal, ND

Title

Owner

Phone

(503) 960-2162

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1275969602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 SE RHONE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062962",
            "telephone_number": "503-960-2162",
            "fax_number": "503-967-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 SE RHONE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062962",
            "telephone_number": "503-960-2162",
            "fax_number": "503-967-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE CITY HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "CORTAL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-960-2162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OR",
            "license": "1917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1917",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI TYPE 1",
            "identifier": "1609128479",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose City Dialysis, LLC
• Rose City Dialysis, LLC
• Rose City Dialysis, LLC
• Rose City Dialysis, LLC
• Rose City Drug & Alcohol Detox Center of Portland LLC
• Rose City Home Health Care Inc
• Rose City House Calls LLC
• Rose City Internal Medicine PC
• Rose City Laboratories, LLC
• Rose City Medical LLC

• Health Service Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Health Service Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.