NPIMap

Organization Active NPI

Pacific Allergy LLC

Doing business as Pacific Allergy & Asthma

  • Allergy & Immunology Physician
  • Beaverton, OR
National Provider Identifier
1992303317
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
PACIFIC ALLERGY LLC
Doing business as
Pacific Allergy & Asthma
Practice address
5040 SW Griffith Dr Ste 201
Beaverton, OR 97005-8721
Phone
(503) 486-4481
Fax
(570) 243-0932
NPI assigned
Oct 16, 2020
Last updated
Apr 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Dr. Alexander Chan Yu, MD, PHDNPI 1760614283
Title
Member, Owner
Phone
(503) 486-4481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

5040 SW Griffith Dr Ste 201
Beaverton, OR 97005-8721

Mailing address

PO Box 10562
Portland, OR 97296-0562

Other names 1

  • Pacific Allergy & Asthma Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308001943 OR Part B Supplier - Clinic/Group Practice 5698185734 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, OR

National Provider Directory

National Provider Directory

Locations

14631 SW Millikan Way
Ste 60
Beaverton, OR 97003

101 E 3rd St
The Dalles, OR 97058
Phone (503) 245-8060

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1992303317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10562",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972960562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 SW GRIFFITH DR STE 201",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058721",
            "telephone_number": "503-486-4481",
            "fax_number": "570-243-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ALLERGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "YU",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "CHAN",
        "authorized_official_title_or_position": "MEMBER, OWNER",
        "authorized_official_telephone_number": "503-486-4481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Allergy & Asthma",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific Allergy & Asthma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.

Verify at the official NPI Registry.