Organization Active NPI

Professional Health Care LLC

  • Health Service Clinic/Center
  • Portland, OR
National Provider Identifier
1477798379
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
AP30003743 Issued in WA
Legal business name
PROFESSIONAL HEALTH CARE LLC
Practice address
135 SE 102ND Ave
Portland, OR 97216-2703
Phone
(503) 258-9800
Fax
(503) 258-8311
NPI assigned
Dec 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Mr. Stephen Allred, NP
Title
Clinical Director
Phone
(503) 258-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X AP30003743 WA Primary

Addresses

Primary practice location

135 SE 102ND Ave
Portland, OR 97216-2703

Mailing address

135 SE 102ND Ave
Portland, OR 97216-2703
Phone (503) 258-9800

Other names 1

  • Get A Flu Shot.com Doing business as

National Provider Directory

National Provider Directory

Locations

135 SE 102nd Ave
Portland, OR 97216
Phone (503) 258-9800

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1477798379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162703",
            "telephone_number": "503-258-9800",
            "fax_number": "503-258-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162703",
            "telephone_number": "503-258-9800",
            "fax_number": "503-258-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "503-258-9800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "AP30003743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Get A Flu Shot.com",
            "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 Dec 5, 2008; 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.