Oregon Scottish Rite Clinics

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

235Z00000X Issued in OR

Legal business name

OREGON SCOTTISH RITE CLINICS

Practice address

5125 SW Macadam Ave
Suite 200
Portland, OR 97239-3809

Phone

(503) 226-1048

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Phill Levinson, PHD SLP

Title

Executive Director

Phone

(503) 226-1048

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Oregon Scottish Rite Clinics2 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.

• Oregon Scottish Rite Clinics

  • Speech-Language Pathologist
  • Portland, OR
  • NPI 1154462737
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Nicole Deymonaz Tate, SLP

  • Speech-Language Pathologist
  • Portland, OR
  • NPI 1487896155
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1710023247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 NE 80TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972184211",
            "telephone_number": "503-282-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 SW MACADAM AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393809",
            "telephone_number": "503-226-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON SCOTTISH RITE CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "LEVINSON",
        "authorized_official_first_name": "PHILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-226-1048",
        "authorized_official_credential": "PHD SLP"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "OR",
            "license": "235Z00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "838353006",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247347",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oregon Pulmonary Associates, P.C.
• Oregon Recovery Alliance LLC
• Oregon Rehabilitation Medicine PC
• Oregon Relief Resource Center LLC
• Oregon Scottish Rite Clinics
• Oregon Sleep and Pulmonary, LLC (Oregon Sleep Associates)
• Oregon Speech & Language
• Oregon Sports Medicine Associates (Sports Medicine Oregon)
• Oregon St. Martin Charities Org (St. Martin Charities LLC)
• Oregon Surgical Consultants PC

• Voluntary or Charitable Agency in Portland, OR
• Providers in Portland, OR by specialty
• Voluntary or Charitable Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.