NPIMap

Organization Active NPI

Liza Samson MD LLC

  • Primary Care Clinic/Center
  • Portland, OR
National Provider Identifier
1346574373
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD22590 Issued in OR
Legal business name
LIZA SAMSON MD LLC
Practice address
2456 NW Northrup St
Suite 1a
Portland, OR 97210-3253
Phone
(503) 705-5753
NPI assigned
Sep 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Dr. Liza De la Cruz Samson, M.D.
Title
Solo Practitioner
Phone
(503) 705-5753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD22590 OR Primary

Addresses

Primary practice location

2456 NW Northrup St
Suite 1a
Portland, OR 97210-3253

Mailing address

2456 NW Northrup St
Suite 1a
Portland, OR 97210-3253
Phone (503) 705-5753

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1346574373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST",
            "address_2": "SUITE 1A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-705-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST",
            "address_2": "SUITE 1A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-705-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIZA SAMSON MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "DE LA CRUZ",
        "authorized_official_title_or_position": "SOLO PRACTITIONER",
        "authorized_official_telephone_number": "503-705-5753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD22590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 12, 2012; 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.