NPIMap

Organization Active NPI

Portland Vamc

  • VA Clinic/Center
  • Lincoln City, OR
National Provider Identifier
1639722275
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
PORTLAND VAMC
Practice address
1105 SE Jetty Ave Ste C
Lincoln City, OR 97367-2604
Phone
(702) 341-3164
Fax
(702) 341-3503
NPI assigned
Jul 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Erin Denise Potter
Title
Npi Team Lead
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

1105 SE Jetty Ave Ste C
Lincoln City, OR 97367-2604

Mailing address

PO Box 94414
Cleveland, OH 44101-4414
Phone (702) 341-3164

Other names 1

  • LINCOLN CITY VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Portland Vamc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1639722275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94414",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014414",
            "telephone_number": "702-341-3164",
            "fax_number": "702-341-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE JETTY AVE STE C",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672604",
            "telephone_number": "702-341-3164",
            "fax_number": "702-341-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM LEAD",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINCOLN CITY VA CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "LINCOLN CITY VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lincoln City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.