Active NPI
Professional Health Care LLC
- Health Service Clinic/Center
- Portland, OR
National Provider Identifier
1477798379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- AP30003743
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.