SURGERY CENTER AT ST. VINCENT, LLC (NPI# 1316449168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316449168 |
| Entity Type | Organization |
| Organization Name | SURGERY CENTER AT ST. VINCENT, LLC |
| Other Organization Name | EAST PAVILION SURGERY CENTER |
| Practice Address |
9135 Sw Barnes Rd Ste 161 Portland OR 97225 |
| Mailing Address |
9135 Sw Barnes Rd Ste 161 Portland OR 97225-6646 |
| Practice Telephone | 9713397791 |
| Mailing Telephone | 9713397791 |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | MR. BRUCE DUDLEY (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 9713397791 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| East Pavilion Surgery Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9135 Sw Barnes Rd, Portland, OR 972256646 | 2052637863 | 2054398875 |
| 9155 Sw Barnes Rd Ste 171, Portland, OR 972256625 | 2052637863 | 2054398875 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SURGERY CENTER AT ST. VINCENT, LLC | 569 Brookwood Village, Suite 901, Birmingham, AL 35209 |
| Street Address |
9135 SW BARNES RD STE 161 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| 1184021917 | Justin Rooney | Massage Therapist | 4475 Sw Scholls Ferry Rd., West Hills Office Plaza, #210, Portland, OR 97225 | 2014-11-21 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
| 1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
| 1780959007 | Columbia River Surgery Center LLC | Clinic/Center | 9820 Ne Cascades Pkwy, Portland, OR 97220-6825 | 2012-03-20 |
| 1245471788 | Pacific Cataract and Laser Institute Inc PC | Clinic/Center | 1331 Nw Lovejoy Street, Suite 750, Portland, OR 97209 | 2009-03-12 |
| 1518022615 | Futures Outpatient Surgical Center | Clinic/Center | 1849 Nw Kearney St Ste 302, Portland, OR 97209-1453 | 2006-12-27 |
| 1245336411 | Lovejoy Surgicenter Inc. | Clinic/Center | 933 Nw 25th Ave, Portland, OR 97210-2829 | 2006-09-15 |
| 1710992680 | Ambulatory Surgical Center | Clinic/Center | 10201 Se Main St Ste 20, Portland, OR 97216-2937 | 2006-07-29 |
| 1609896539 | Cedar Hills Ambulatory Surgery Center LLC | Clinic/Center | 10305 Sw Park Way Ste 101, Portland, OR 97225-5033 | 2006-07-21 |
| 1376599381 | Eyecare Medical Group | Clinic/Center | 53 Sewall Street, Portland, ME 04102-2625 | 2006-05-25 |
| 1518382936 | Spectrum Healthcare Partners, P.a | Clinic/Center | 33 Sewall St, Portland, ME 04102-2603 | 2014-02-21 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.