Pacific Healthcare Providers, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PACIFIC HEALTHCARE PROVIDERS, LLC

Practice address

14355 SW Allen Blvd Ste 130
Beaverton, OR 97005-4700

Phone

(503) 956-9432

NPI assigned

Apr 22, 2022

Organization subpart

No

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

Authorized official

Name

Leane Beth Wadsworth

Title

Insurance Coordinator

Phone

(503) 312-2279

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1720722051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 SW MURRAY BLVD STE 516",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970084421",
            "telephone_number": "503-956-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14355 SW ALLEN BLVD STE 130",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054700",
            "telephone_number": "503-956-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEALTHCARE PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "LEANE",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "503-312-2279"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639113590",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Beaverton",
            "affiliation": "N",
            "endpointDescription": "HSC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HSC",
            "address_1": "14355 SW Allen Blvd Ste 130",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970054700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald Pacheco
• Pacific Allergy LLC
• Pacific Eye Group, PC
• Pacific Eye Group, PC
• Pacific Healthcare Group
• Pacific Natural Family Medicine, LLC
• Pacific Northwest Dental, LLC
• Pacific Northwest Renal Services, L.L.C.
• Pacific Northwest Renal Services, L.L.C.
• Pacific Oncology PC

• Internal Medicine Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.