NPIMap

Organization Active NPI

Premise Health of Oregon Medical PC

  • Multi-Specialty Clinic/Center
  • Portland, OR
National Provider Identifier
1992470504
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF OREGON MEDICAL PC
Practice address
12106 NE Ainsworth Cir Ste 5
Portland, OR 97220-9001
Phone
(541) 225-5551
Fax
(301) 244-0995
NPI assigned
Aug 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

12106 NE Ainsworth Cir Ste 5
Portland, OR 97220-9001

Mailing address

5500 Maryland Way
Brentwood, TN 37027-7048

Other names 1

  • Leatherman - Portland Doing business as

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
38D2145671Premise Health of Oregon Medical, PC12106 NE Ainsworth Circle Suite 5, Portland, OR 97220Certificate of waiverMar 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Deschutes Juvenile Detention Center Clinic9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1992470504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12106 NE AINSWORTH CIR STE 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209001",
            "telephone_number": "541-225-5551",
            "fax_number": "301-244-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OREGON MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leatherman - Portland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Leatherman - Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.