Sports Orthopaedic and Regenerative Medicine Clinic of Oregon, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SPORTS ORTHOPAEDIC AND REGENERATIVE MEDICINE CLINIC OF OREGON, LLC

Doing business as

SOAR Clinic of Oregon
SOAR Ortho

Practice address

6485 SW Borland Rd Ste a
Tualatin, OR 97062-9762

Phone

(503) 427-9066

Fax

(503) 966-7075

NPI assigned

Jan 17, 2024

Last updated

Jan 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grace P Williams

Title

Business Manager

Phone

(503) 427-9066

Specialties & licenses 1

Addresses

Other names 2

• SOAR Clinic of Oregon Doing business as
• SOAR Ortho Doing business as

Locations

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1518728500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6485 SW BORLAND RD STE A",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629762",
            "telephone_number": "503-427-9066",
            "fax_number": "503-966-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6485 SW BORLAND RD STE A",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629762",
            "telephone_number": "503-427-9066",
            "fax_number": "503-966-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS ORTHOPAEDIC AND REGENERATIVE MEDICINE CLINIC OF OREGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "503-427-9066"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOAR Clinic of Oregon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOAR Ortho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.