Active NPI
Oregon Health Authority Public Health Financial Services
- Clinical Medical Laboratory
- Hillsboro, OR
National Provider Identifier
1750408159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES
- Practice address
- 3150 NW 229TH Ave Ste 100
Hillsboro, OR 97124-7251 - Phone
- (503) 693-4100
- Fax
- (503) 693-5600
- NPI assigned
- Mar 23, 2007
- Last updated
- May 14, 2015
- Organization subpart
- Yes
- Parent organization
- OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sarah Humphrey
- Title
- Client Services Coordinator
- Phone
- (503) 693-4124
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | NU | Primary |
Addresses
Primary practice location
3150 NW 229TH Ave Ste 100
Hillsboro, OR 97124-7251
Mailing address
3150 NW 229TH Ave Ste 100
Hillsboro, OR 97124-7251
Phone (503) 693-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258202 | Medicaid | OR | |
| 101185 | Other | OR | MEDICARE ID - INDEPENDENT LAB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160107001484 | OR | Part B Supplier - Independent Clinical Laboratory | 4486956448 | Practice locations: Hillsboro, OR |
National Provider Directory
National Provider Directory- Part of
- Ooregon Health Authority
Locations
7202 NE Evergreen Pkwy
Ste 100
Hillsboro, OR 97124
Phone (503) 693-4100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431561600000",
"number": "1750408159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 NW 229TH AVE STE 100",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247251",
"telephone_number": "503-693-4100",
"fax_number": "503-693-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 NW 229TH AVE STE 100",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247251",
"telephone_number": "503-693-4100",
"fax_number": "503-693-5600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "OREGON HEALTH AUTHORITY PUBLIC HEALTH FINANCIAL SERVICES",
"enumeration_date": "2007-03-23",
"last_updated": "2015-05-14",
"status": "A",
"authorized_official_last_name": "HUMPHREY",
"authorized_official_first_name": "SARAH",
"authorized_official_title_or_position": "CLIENT SERVICES COORDINATOR",
"authorized_official_telephone_number": "503-693-4124"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "258202",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID - INDEPENDENT LAB",
"identifier": "101185",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
- Open Door Housingworks
- Oral and Facial Surgery
- Oregon Continental Home Health Care, Inc
- Oregon CVS Pharmacy LLC (CVS Pharmacy #16140)
- Oregon Health & Science University (Medicine Shoppe Pharmacy)
- Oregon Luna Care Physical Therapy LLC
- Oregon Mindful Wellness, LLC (Oregon Mindful Wellness)
- Oregon Mobile Care Dental Services
- Oregon Rheumatology Clinics, LLC (Hillsboro Rheumatology)
- Orenco Acupuncture & Wellness Clinic, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.