Active NPI
Legacy Clinics LLC
- Clinic/Center
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- LEGACY CLINICS LLC
- Practice address
- 1130 NW 22ND Ave Ste 220
Portland, OR 97210-2969 - Phone
- (503) 413-2901
- NPI assigned
- Jul 22, 2006
- Last updated
- Jan 20, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sarah Jensen
- Title
- VP Finance
- Phone
- (503) 415-5145
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | 698327-81 | OR | |
| Midwife | 176B00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Internal Medicine Physician | 207R00000X | |||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | |||
| Neurological Surgery Physician | 207T00000X | |||
| Maternal & Fetal Medicine Physician | 207VM0101X | |||
| Obstetrics Physician | 207VX0000X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Diagnostic Radiology Physician | 2085R0202X | |||
| Vascular Surgery Physician | 2086S0129X | |||
| Hospitalist Physician | 208M00000X |
Addresses
Primary practice location
1130 NW 22ND Ave Ste 220
Portland, OR 97210-2969
Mailing address
PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 277776 | Medicaid | OR | |
| 804702000 | Other | OR | REGENCE BLUE CROSS |
| 9646449 | Medicaid | WA | |
| 022930 | Medicaid | OR | |
| 134334 | Medicaid | OR | |
| 286709 | Medicaid | OR | |
| 226982 | Medicaid | OR | |
| 286482 | Medicaid | OR | |
| 227592 | Medicaid | OR | |
| 7098429 | Medicaid | WA | |
| 7101124 | Medicaid | WA | |
| 227692 | Medicaid | OR | |
| 286717 | Medicaid | OR | |
| 7130628 | Medicaid | WA | |
| 277799 | Medicaid | OR | |
| 286822 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031117000089 | OR | Part B Supplier - Clinic/Group Practice | 0244144004 |
Receives reassigned benefits from 1,593 practitioners 1 other NPI on this enrollment |
| O20050627000226 | WA | Part B Supplier - Clinic/Group Practice | 0244144004 |
Receives reassigned benefits from 129 practitioners Practice locations: Vancouver, WA |
| O20190109000177 | OR | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 0244144004 | Practice locations: Beaverton, OR |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Legacy Medical Group Firwood
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
0244144004
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Legacy Medical Group Firwood
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
O20031117000089
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0973546 | Legacy Clinic Northwest | Certificate of waiver | Feb 24, 2028 |
National Provider Directory
National Provider DirectoryLocations (25 of 26)
2725 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 352-6000
2725 SW Cedar Hills Blvd
Ste 255
Beaverton, OR 97005
Phone (503) 415-4150
1900 McLoughlin Blvd
Ste 67
Oregon City, OR 97045
1040 NW 22nd Ave
Ste 420
Portland, OR 97210
Phone (503) 229-7566
1130 NW 22nd Ave
Ste 420
Portland, OR 97210
Phone (503) 413-4992
1244 NW Marshall St
Portland, OR 97209
Phone (971) 232-8620
2222 NW Lovejoy St
Ste 3
Portland, OR 97210
Phone (503) 413-5764
2222 NW Lovejoy St
Ste 411
Portland, OR 97210
Phone (503) 227-1409
2800 N Vancouver Ave
#502
Portland, OR 97227
300 N Graham St
Ste 320
Portland, OR 97227
Phone (503) 281-0448
3025 N Vancouver Ave
Portland, OR 97227
Phone (503) 413-1500
501 N Graham St
Ste 280
Portland, OR 97227
Phone (503) 249-8622
501 N Graham St
Ste 500
Portland, OR 97227
Phone (503) 229-8455
8339 SW Beaverton Hillsdale Hwy
Portland, OR 97225
Phone (503) 245-5639
500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101
21430 SW Langer Farms Pkwy
Ste 158
Sherwood, OR 97140
Phone (971) 808-0655
19260 SW 65th Ave
Ste 140
Tualatin, OR 97062
Phone (503) 413-8654
19875 SW 65th Ave
Ste 250
Tualatin, OR 97062
Phone (503) 413-5525
2020 8th Ave
Ste B
West Linn, OR 97068
Phone (503) 655-3320
21900 Willamette Dr
Ste 209
West Linn, OR 97068
Phone (971) 274-0038
13009 NE Highway 99
Ste 109
Vancouver, WA 98686
Phone (360) 667-5840
200 NE Mother Joseph Pl
Ste 410
Vancouver, WA 98664
Phone (503) 413-3580
2101 NE 139th St
Ste 2
Vancouver, WA 98686
Phone (360) 487-2870
2101 NE 139th St
Ste 2608
Vancouver, WA 98686
Phone (360) 487-2870
305 SE Chkalov Dr
Ste 170
Vancouver, WA 98683
Phone (360) 799-3912
Practitioners & affiliated clinicians
Practitioners 1,641
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Cardiovascular Disease Physician
- Tualatin, OR
- NPI 1124319330
Internal Medicine
-
- Internal Medicine Physician
- Portland, OR
- NPI 1831488444
-
- Clinical Social Worker
- Portland, OR
- NPI 1386254597
-
- Internal Medicine Physician
- Portland, OR
- NPI 1194839225
-
- Obstetrics & Gynecology Physician
- Portland, OR
- NPI 1851970024
-
- Internal Medicine Physician
- Gresham, OR
- NPI 1255369559
-
- Internal Medicine Physician
- Portland, OR
- NPI 1366071458
-
- Anesthesiology Physician
- Portland, OR
- NPI 1194276931
-
- Obstetrics & Gynecology Physician
- Gresham, OR
- NPI 1558777342
-
- Family Nurse Practitioner
- Portland, OR
- NPI 1053294041
-
- Internal Medicine Physician
- Lake Oswego, OR
- NPI 1710932421
-
- Internal Medicine Physician
- Portland, OR
- NPI 1568802361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768867200000",
"number": "1902827272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3777",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083777",
"telephone_number": "503-413-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE STE 220",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102969",
"telephone_number": "503-413-2901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY CLINICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-22",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A",
"authorized_official_last_name": "JENSEN",
"authorized_official_first_name": "SARAH",
"authorized_official_title_or_position": "VP FINANCE",
"authorized_official_telephone_number": "503-415-5145"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "OR",
"license": "698327-81",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277776",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE CROSS",
"identifier": "804702000",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9646449",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022930",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134334",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286709",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "226982",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286482",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227592",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7098429",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7101124",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227692",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286717",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7130628",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277799",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286822",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
- Noelle Shipman Lefitz, CNM
- Anthony Todd Lefkowicz, MS, MOT
- Kathy Louise Lefor, LPC
- Michael John Lefor, MD
- Legacy Care LLC (Legacy Care)
- Legacy Emanuel Hospital & Health Center (Unity Center for Behavioral Health-PES)
- Legacy Emanuel Hospital & Health Center (Legacy Emanuel Hospital Adult Psychiatric Unit)
- Legacy Emanuel Hospital & Health Center (Caresnw)
- Legacy Emanuel Hospital & Health Center (Legacy Emanuel Hospital Adolescent Psychiatric Unit)
- Legacy Emanuel Hospital & Health Center (Legacy Laboratory Services)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.