Pacific Primary Care and Integrative Health, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PACIFIC PRIMARY CARE AND INTEGRATIVE HEALTH, INC.

Practice address

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

Phone

(503) 213-3800

Fax

(503) 747-5345

NPI assigned

May 23, 2019

Last updated

May 23, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

PACIFIC PRIMARY CARE AND INTEGRATIVE HEALTH INCAs reported in NPPES

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

Authorized official

Name

Dr. Jenna Michelle Wilson Crain, ND

Title

Dir. of Clinical Outcomes

Phone

(503) 487-3001

Specialties & licenses 2

Addresses

Tax ID family

Pacific Primary Care and Integrative Health Inc2 organizations share this tax ID, including this one

Part of

Pacific Primary Care and Integrative Health Inc

Other organizations with this tax ID 1

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

• Pacific Primary Care and Integrative Health, Inc.

  • Family Medicine Physician
  • Portland, OR
  • NPI 1760049886
  NPD tax ID

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1528625639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452799",
            "telephone_number": "503-487-3001",
            "fax_number": "503-656-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-213-3800",
            "fax_number": "503-747-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PRIMARY CARE AND INTEGRATIVE HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC PRIMARY CARE AND INTEGRATIVE HEALTH INC",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "WILSON CRAIN",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIR. OF CLINICAL OUTCOMES",
        "authorized_official_telephone_number": "503-487-3001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Northwest Dental, LLC (Pacific NW Dental)
• Pacific Northwest Renal Services, L.L.C. (PNRS Twin Oaks)
• Pacific Northwest Renal Services, L.L.C. (PNRS Beaverton Dialysis)
• Pacific Oncology PC
• Pacific Oncology PC
• Pacific Rose Lactation
• Pacific University
• Pacificemdr LLC
• Pacificnest RTH LLC
• Taylor T Paden-Matsuzaki

• Family Medicine Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.