Organization Active NPI

Pacific Digestive Associates

  • Gastroenterology Physician
  • Clackamas, OR
National Provider Identifier
1396716627
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PACIFIC DIGESTIVE ASSOCIATES
Practice address
15775 SE 82ND Dr
Clackamas, OR 97015-8551
Phone
(503) 722-9155
Fax
(503) 722-0420
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Linda J Williams
Title
Office Manager
Phone
(503) 496-0354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X OR Primary

Addresses

Primary practice location

15775 SE 82ND Dr
Clackamas, OR 97015-8551

Mailing address

15775 SE 82ND Dr
Clackamas, OR 97015-8551
Phone (503) 722-9155

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396716627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15775 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158551",
            "telephone_number": "503-722-9155",
            "fax_number": "503-722-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15775 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158551",
            "telephone_number": "503-722-9155",
            "fax_number": "503-722-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DIGESTIVE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-496-0354",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.