Organization Active NPI

Halcyon Medical LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1477038941
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HALCYON MEDICAL LLC
Practice address
2232 NW Pettygrove St
Portland, OR 97210-2372
Phone
(503) 395-7736
NPI assigned
Oct 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Dr. Chad Muncrief, NDNPI 1710461900
Title
Member
Phone
(503) 839-2376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2232 NW Pettygrove St
Portland, OR 97210-2372

Mailing address

PO Box 14772
Portland, OR 97293-0772

Other names 1

  • Oregon Medical & Laser Doing business as

National Provider Directory

National Provider Directory

Locations

2232 NW Pettygrove St
Portland, OR 97210
Phone (503) 552-1552

3537 N Williams Ave
Portland, OR 97227
Phone (503) 309-8622

Practitioners & affiliated clinicians

Practitioners 1

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": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1477038941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14772",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972930772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 NW PETTYGROVE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102372",
            "telephone_number": "503-395-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALCYON MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "MUNCRIEF",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-839-2376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Medical & Laser",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 29, 2024; 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.