Portland Iop, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PORTLAND IOP, LLC

Practice address

748 SE 181St Ave
Portland, OR 97233-4945

Phone

(503) 825-7046

NPI assigned

Jul 10, 2015

Organization subpart

No

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

Authorized official

Name

Alixaundrea Corrin Poli

Title

Office Manager

Phone

(360) 969-4787

Specialties & licenses 1

Addresses

Other names 1

• Klean Gresham Doing business as

Tax ID family

Klean Gresham2 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.

• Portland Iop, LLC

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1912397977
  NPD tax ID

Locations

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1669856571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 NW THURMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102202",
            "telephone_number": "503-825-7046",
            "fax_number": "503-432-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 SE 181ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334945",
            "telephone_number": "503-825-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND IOP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "POLI",
        "authorized_official_first_name": "ALIXAUNDREA",
        "authorized_official_middle_name": "CORRIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-969-4787"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klean Gresham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Portland Hypertension & Nephrology Clinic LLP
• Portland Injury &Rehab Center
• Portland Insight Psychotherapy
• Portland Integrative Counseling Center
• Portland Internal Medicine Offices of James V. Skavaril MD LLC
• Portland Iop, LLC
• Portland Joint Reconstruction Clinic, P.C.
• Portland Lifestyle Counseling, LLC
• Portland Massage and Chiropractic Services LLC
• Portland Massage Arts LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.