NPIMap

Organization Active NPI

Portland Ear Nose & Throat

  • Otolaryngology Physician
  • Portland, OR
National Provider Identifier
1598835688
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD21133 Issued in OR
Legal business name
PORTLAND EAR NOSE & THROAT
Practice address
10535 NE Glisan
#350
Portland, OR 97220
Phone
(503) 408-1323
Fax
(503) 408-4463
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mrs. Suzanne S Cleland Zamudio, MDNPI 1609883768
Title
MD Owner
Phone
(503) 408-1323

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
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X MD21133 OR Primary

Addresses

Primary practice location

10535 NE Glisan
#350
Portland, OR 97220

Mailing address

10535 NE Glisan
#350
Portland, OR 97220
Phone (503) 408-1323

Other identifiers 1

IdentifierTypeStateIssuer
151216MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Portland Ear Nose and Throat2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2850 SE Powell Valley Rd
Ste 207
Gresham, OR 97080

10535 NE Glisan St
Ste 350
Portland, OR 97220
Phone (503) 408-1323

2705 E Lincoln Ave
Sunnyside, WA 98944
Phone (509) 836-4848

Practitioners & affiliated clinicians

Practitioners 8

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1598835688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN",
            "address_2": "#350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-408-1323",
            "fax_number": "503-408-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN",
            "address_2": "#350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-408-1323",
            "fax_number": "503-408-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND EAR NOSE & THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "CLELAND ZAMUDIO",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "503-408-1323",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD21133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151216",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 3, 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.