Professional Health Care LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

081047114N3 Issued in OR

Legal business name

PROFESSIONAL HEALTH CARE LLC

Practice address

135 SE 102ND Ave
Portland, OR 97216-2703

Phone

(503) 258-9800

Fax

(503) 258-8311

NPI assigned

Dec 19, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Allred, ARNP

Title

Nurse Practitioner

Phone

(503) 258-9800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Get A Flu Shot.com Doing business as

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229644800000",
    "number": "1760628838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162703",
            "telephone_number": "503-258-9800",
            "fax_number": "503-258-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162703",
            "telephone_number": "503-258-9800",
            "fax_number": "503-258-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "503-258-9800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "OR",
            "license": "081047114N3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213900",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Get A Flu Shot.com",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirley Ann Proctor, MSW
• Gabrielle Prodigue, MA
• Becky Lynn Prodoehl, BS
• Professional 205 Pharmacy
• Professional Health Care LLC
• Professional Home Care Services
• Professional Medical Services LLC
• Professional Medical Services LLC
• Professional Radiology of Oregon LLC
• Professionl Pharmacy

• Health Service Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Health Service Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.