Organization

Providence Portland Medical Center

May also be knows as Providence Integrative Medicine East

Clinic/Center in Portland, OR(View on Map)

Legal Business Name

Providence Portland Medical Center

Also Known As

Providence Integrative Medicine East

NPI Number

1134355985

NPI Type

Organization

Enumeration Date

06/08/2009

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 3158
4805 NE GLISAN ST

City

Portland
Portland

State

OR
OR

Postal Code

97208-3158
97213-2933

Country

US
US

Telephone Number

N/A
(503) 215-6503

Authorized Official

Name

William Olson

Title or Position

CHIEF FINANCIAL OFFICER

Telephone Number

(503) 215-7384

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/08/2009

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