NPIMap

Organization Active NPI

Oregon City Medical

  • Primary Care Clinic/Center
  • Beaverton, OR
National Provider Identifier
1457604654
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OREGON CITY MEDICAL
Practice address
17200 NW Corridor CT
Suite 110
Beaverton, OR 97006-3295
Phone
(503) 213-3800
Fax
(503) 747-5345
NPI assigned
Oct 25, 2012
Last updated
Oct 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Keith Haines
Title
Manager
Phone
(503) 213-3800

Specialties & licenses 1

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

Addresses

Primary practice location

17200 NW Corridor CT
Suite 110
Beaverton, OR 97006-3295

Mailing address

17200 NW Corridor CT
Suite 110
Beaverton, OR 97006-3295
Phone (503) 213-3800

Other names 1

  • Beaverton Family Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Beaverton Family Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1457604654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "SUITE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-213-3800",
            "fax_number": "503-747-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "SUITE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-213-3800",
            "fax_number": "503-747-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON CITY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-213-3800"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaverton Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

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