Organization Active NPI

The Oregon Clinic PC

  • Specialist
  • Vancouver, WA
National Provider Identifier
1366699464
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
160412 Issued in OR
Legal business name
THE OREGON CLINIC PC
Practice address
315 SE Stonemill Dr
Suite 220
Vancouver, WA 98684-6998
Phone
(503) 963-2707
Fax
(503) 963-2802
NPI assigned
Aug 20, 2008
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Richard L Jamison, M.D.NPI 1770553679
Title
Ceo President
Phone
(503) 963-2801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 160412 OR Primary

Addresses

Primary practice location

315 SE Stonemill Dr
Suite 220
Vancouver, WA 98684-6998

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000426 WA Part B Supplier - Clinic/Group Practice 2860390408 Receives reassigned benefits from 2 practitioners
Practice locations: Vancouver, WA

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1366699464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SE STONEMILL DR",
            "address_2": "SUITE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846998",
            "telephone_number": "503-963-2707",
            "fax_number": "503-963-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OREGON CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "503-963-2801",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "160412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.