Organization Active NPI

Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1902827272
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
277776MedicaidOR
804702000OtherORREGENCE BLUE CROSS
9646449MedicaidWA
022930MedicaidOR
134334MedicaidOR
286709MedicaidOR
226982MedicaidOR
286482MedicaidOR
227592MedicaidOR
7098429MedicaidWA
7101124MedicaidWA
227692MedicaidOR
286717MedicaidOR
7130628MedicaidWA
277799MedicaidOR
286822MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0973546Legacy Clinic Northwest1130 NW 22ND Suite 220, Portland, OR 97210Certificate of waiverFeb 24, 2028

National Provider Directory

National Provider Directory

Locations (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.

View all 1,641

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

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.

Verify at the official NPI Registry.