PORTLAND VAMC (NPI# 1710174974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710174974 |
| Entity Type | Organization |
| Organization Name | PORTLAND VAMC |
| Other Organization Name | FAIRVIEW VA CLINIC |
| Practice Address |
1800 Ne Market Drive Fairview OR 97024-9998 |
| Mailing Address |
Po Box 94414 Cleveland OH 44101-4414 |
| Practice Telephone | 7023413164 |
| Mailing Telephone | 7023413164 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2017-11-01 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FAIRVIEW VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346657491 | Portland Vamc | Clinic/Center | 308 Sw 1st Ave, Suite 155, Portland, OR 97204-3400 | 2014-07-21 |
| 1104233295 | Portland Vamc | Clinic/Center | 704 Veterans Drive, The Dalles, OR 97058-9998 | 2014-07-21 |
| 1114151248 | Portland Vamc | Clinic/Center | 1925 Ne Stucki Ave Ste 300, Hillsboro, OR 97006-6945 | 2009-05-04 |
| 1720022940 | Portland Vamc | Clinic/Center | 91400 S Neacoxie Blvd, Building 7315, Warrenton, OR 97146-7267 | 2006-06-16 |
| 1376581371 | Portland Vamc | Clinic/Center | 1750 Mcgilchrist St Se, Suite 130, Salem, OR 97302-1691 | 2006-06-02 |
| 1184675803 | Portland Vamc | Clinic/Center | 2650 Ne Courtney Dr, Bend, OR 97701-7636 | 2006-05-15 |
| 1639722275 | Portland Vamc | Clinic/Center | 4422 Ne Devils Lake Blvd Ste 2, Lincoln City, OR 97367-5000 | 2019-07-23 |
| 1497162556 | Portland Vamc | Clinic/Center | 1010 Sw Coast Hwy, Newport, OR 97365-5288 | 2014-07-21 |
| 1982957510 | Portland Vamc | Clinic/Center | 1750 Blankenship Rd, Suite 300, West Linn, OR 97068-5101 | 2012-10-19 |
| 1255424685 | Portland Vamc | Department of Veterans Affairs (VA) Pharmacy | 1601 E 4th Plain Blvd, Vancouver, WA 98661-3713 | 2006-09-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PORTLAND VAMC | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97207-2964 |
| Street Address |
1800 NE MARKET DRIVE |
| City | FAIRVIEW |
| State | OR |
| Zip Code | 97024-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528338423 | Denise Irene Houck | Nurse Practitioner | 1800 Ne Market Drive, Fairview, OR 97024 | 2012-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255792560 | Brent Labhart | Counselor | 17720 Ne Halsey, Fairview, OR 97024 | 2016-03-14 |
| 1720325954 | Glen R Edgerton | Internal Medicine | 3797 Ne Fairview Lake Way, Fairview, OR 97024 | 2013-01-08 |
| 1073657003 | Aoife O'sullivan | Family Medicine | Hyster-yale, 4000 Ne Blue Lake Road, Fairview, OR 97024 | 2007-02-15 |
| 1780240713 | Christie Ellen Thompson | Massage Therapist | 1659 Ne Market Drive, Fairview, OR 97024 | 2019-05-15 |
| 1003325531 | Daniel L Hubbell | Chiropractor | 1659 Ne Market Dr, Fairview, OR 97024 | 2017-09-27 |
| 1467625632 | Lisa Camille Gibson | Registered Nurse | 722 Ne 162nd Ave, Albertina Kerr Center Youth & Family Services, Portland, OR 97024 | 2008-04-09 |
| 1447624663 | Western Psychological and Counseling Services PC | Health Maintenance Organization | 22070 Ne Chinook Way, Fairview, OR 97024-2647 | 2015-11-26 |
| 1891815957 | Robert Craig Stassi I | Chiropractor | 1606 Ne 223rd Ave, Fairview, OR 97024-2662 | 2007-03-30 |
| 1811168925 | Laurie Anne Mcadam | Occupational Therapy Assistant | 100 Bridge St, Fairview, OR 97024-2666 | 2008-03-17 |
| 1265052708 | Jessica A Steinhebel | Music Therapist | 200 Cedar St, Fairview, OR 97024-3740 | 2020-04-24 |
| Find all providers in zip 97024 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841714607 | Roseburg Vamc | Clinic/Center | 211 E 7th Ave Ste 220, Eugene, OR 97401-2722 | 2017-08-02 |
| 1457742538 | Walla Walla Vamc | Clinic/Center | 2 Marine Drive, Suite 103, Boardman, OR 97818-9998 | 2015-02-11 |
| 1710378898 | Walla Walla Vamc | Clinic/Center | 401 Northeast 1st Street, Suite A, Enterprise, OR 97828-1186 | 2015-02-11 |
| 1346657491 | Portland Vamc | Clinic/Center | 308 Sw 1st Ave, Suite 155, Portland, OR 97204-3400 | 2014-07-21 |
| 1104233295 | Portland Vamc | Clinic/Center | 704 Veterans Drive, The Dalles, OR 97058-9998 | 2014-07-21 |
| 1548677602 | Boise Vamc | Clinic/Center | 635 Highway 20 N Ste 4, Hines, OR 97738-9462 | 2014-07-21 |
| 1790038339 | White City Vamc | Clinic/Center | 1877 Williams Highway, Grants Pass, OR 97527 | 2012-10-19 |
| 1114151248 | Portland Vamc | Clinic/Center | 1925 Ne Stucki Ave Ste 300, Hillsboro, OR 97006-6945 | 2009-05-04 |
| 1184812943 | Walla Walla Vamc | Clinic/Center | 202 12th St, La Grande, OR 97850-2879 | 2007-10-05 |
| 1720022940 | Portland Vamc | Clinic/Center | 91400 S Neacoxie Blvd, Building 7315, Warrenton, OR 97146-7267 | 2006-06-16 |
| Find all providers with the same taxonomy | ||||
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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.