LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER (NPI# 1609896174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609896174 |
| Entity Type | Organization |
| Organization Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
1040 Nw 22nd Ave Suite 100 Portland OR 97210-3057 |
| Mailing Address |
1040 Nw 22nd Ave Suite 100 Portland OR 97210 |
| Practice Telephone | 5034133958 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034134449 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | SARAH JENSEN (INTERIM CFO) |
| Authorized Official Telephone | 5034155145 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP-0001427-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NCPDP | 3806051 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1780608216 | Legacy Good Samaritan Hospital and Medical Center | Transplant Surgery | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2006-07-27 |
| 1679597108 | Legacy Good Samaritan Hospital and Medical Center | Psychiatry & Neurology | 1200 Nw 23rd Ave, Portland, OR 97210-2906 | 2006-07-27 |
| 1336162874 | Legacy Good Samaritan Hospital and Medical Center | Psychiatric Unit | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2006-07-25 |
| 1942223482 | Legacy Good Samaritan Hospital and Medical Center | Rehabilitation Unit | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2006-07-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 1015 Nw 22nd Ave, Portland, OR 97210 |
| Washington State Corporations | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER | 1015 Nw 22nd Ave, Portland, OR 97210-3025 |
| Street Address |
1040 NW 22ND AVE SUITE 100 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717852 | Raylene Dianne Coleman | Nurse Practitioner | 1040 Nw 22nd Ave, Suite 420, Portland, OR 97210-3057 | 2005-08-11 |
| 1386204980 | Dorian Ariel Zeidenweber | Student in an Organized Health Care Education/Training Program | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2019-06-17 |
| 1982194429 | Katherine Crawford | Dietitian, Registered | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2018-05-10 |
| 1720537111 | Legacy Health | General Acute Care Hospital | 1040 Nw 22nd Ave, Suite 110, Portland, OR 97210-3057 | 2016-09-26 |
| 1053779801 | Tasha Nicole Searles | Clinical Nurse Specialist | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3057 | 2016-02-08 |
| 1497120380 | Martha Rissmiller | Physical Therapist | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3057 | 2015-12-03 |
| 1427436971 | Claire Hanway | Nurse Practitioner | 1040 Nw 22nd Ave, Suite 520, Portland, OR 97210-3026 | 2015-05-15 |
| 1629401963 | Pui Yi Boey | Ophthalmology | 1040 Nw 22nd Ave, Suite #200, Portland, OR 97210-3057 | 2013-08-09 |
| 1366783631 | David Larson Demill | Ophthalmology | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2013-03-11 |
| 1639414410 | Dewi Kae De Jarnett | Nurse Anesthetist, Certified Registered | 1040 Nw 22nd Ave, Portland, OR 97210-3057 | 2012-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1649800186 | A & S Pharmacy LLC | Pharmacy | 1660 Wildcat Dr, Portland, TX 78374-2830 | 2020-01-23 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1538653654 | Division Pharmacy Inc. | Pharmacy | 10918 Se Division St, Portland, OR 97266-1259 | 2018-06-21 |
| 1659755593 | Portland Professional Pharmacy, LLC | Pharmacy | 11717 Ne Glisan St, Portland, OR 97220-2141 | 2015-07-09 |
| 1992194062 | Professionl Pharmacy | Pharmacy | 10000 Se Main St Ste 201, Portland, OR 97216-2448 | 2015-01-13 |
| 1932597978 | Pharmaca Integrative Pharmacy, Inc | Pharmacy | 240 Nw Lost Springs Terrace, Suite 36, Portland, OR 97229 | 2014-12-29 |
| 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.