Mt. Hood Imaging, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD21140 Issued in OR

Legal business name

MT. HOOD IMAGING, LLC

Practice address

10101 SE Main St
Suite 2004
Portland, OR 97216-2455

Phone

(503) 257-3204

Fax

(503) 255-7208

NPI assigned

Feb 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Leigh Anne Dew, MD

Title

Owner

Phone

(503) 257-3204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1689812430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "SUITE 2004",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-257-3204",
            "fax_number": "503-255-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SE MAIN ST",
            "address_2": "SUITE 2004",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162455",
            "telephone_number": "503-257-3204",
            "fax_number": "503-255-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. HOOD IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "DEW",
        "authorized_official_first_name": "LEIGH ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-257-3204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "MD21140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.