NPIMap

Organization Active NPI

Allergy Clinic LLC

  • Allergy Physician
  • Portland, OR
National Provider Identifier
1679790604
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
13450 Issued in OR
Legal business name
ALLERGY CLINIC LLC
Practice address
511 SW 10TH Ave
Suite 1301
Portland, OR 97205-2732
Phone
(503) 228-0155
Fax
(503) 226-8342
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Thomas O'Hollaren, M.D.NPI 1588723787
Title
Owner
Phone
(503) 228-0155

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
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X 13450 OR Primary

Addresses

Primary practice location

511 SW 10TH Ave
Suite 1301
Portland, OR 97205-2732

Mailing address

511 SW 10TH Ave
Suite 1301
Portland, OR 97205-2732
Phone (503) 228-0155

National Provider Directory

National Provider Directory

Locations

511 SW 10th Ave
Ste 1301
Portland, OR 97205
Phone (503) 228-0155

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": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679790604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "SUITE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "SUITE 1301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-228-0155",
            "fax_number": "503-226-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'HOLLAREN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-228-0155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "OR",
            "license": "13450",
            "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 Aug 22, 2020; 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.