NPIMap

Organization Active NPI

Providence Health & Services Oregon

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
National Provider Identifier
1639524697
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
700006 Issued in OR
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Practice address
5228 NE Hoyt St
Building B
Portland, OR 97213-3055
Phone
(503) 574-9200
NPI assigned
Apr 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Authorized official

Name
Billie Jean Mounts
Title
Chief Reimbursement Officer
Phone
(425) 687-3910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 700006 OR Primary

Addresses

Primary practice location

5228 NE Hoyt St
Building B
Portland, OR 97213-3055

Mailing address

PO Box 3395
Portland, OR 97208-3395
Phone (503) 215-4323

Other names 1

  • Providence Portland Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mary Grant Anp10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1639524697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3395",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083395",
            "telephone_number": "503-215-4323",
            "fax_number": "503-215-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 NE HOYT ST",
            "address_2": "BUILDING B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133055",
            "telephone_number": "503-574-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "MOUNTS",
        "authorized_official_first_name": "BILLIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CHIEF REIMBURSEMENT OFFICER",
        "authorized_official_telephone_number": "425-687-3910"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OR",
            "license": "700006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Portland Medical Center",
            "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 Apr 27, 2016; 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.