NPIMap

Organization Active NPI

Precious Memory Family Medical Clinic LLC

  • Primary Care Clinic/Center
  • Portland, OR
National Provider Identifier
1659821023
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
201250053NP Issued in OR
Legal business name
PRECIOUS MEMORY FAMILY MEDICAL CLINIC LLC
Practice address
7620 NE Killingsworth St Ste 100
Portland, OR 97218-3763
Phone
(503) 858-0202
NPI assigned
Oct 10, 2016
Last updated
Oct 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Morry A Anotta, DNPNPI 1932460631
Title
Provider
Phone
(503) 384-2392

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 201250053NP OR Primary

Addresses

Primary practice location

7620 NE Killingsworth St Ste 100
Portland, OR 97218-3763

Mailing address

7620 NE Killingsworth Suit 100
Portland, OR 97218
Phone (503) 384-2392

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1659821023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 NE KILLINGSWORTH SUIT 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97218",
            "telephone_number": "503-384-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 NE KILLINGSWORTH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972183763",
            "telephone_number": "503-858-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECIOUS MEMORY FAMILY MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "ANOTTA",
        "authorized_official_first_name": "MORRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "503-384-2392",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "201250053NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 26, 2017; 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.