LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER (NPI# 1780608216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780608216 |
| Entity Type | Organization |
| Organization Name | LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
1015 Nw 22nd Ave Portland OR 97210-3025 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5034137711 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034134449 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | SARAH JENSEN (INTERIM CFO) |
| Authorized Official Telephone | 5034155145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | NA | Ambulatory Health Care Facilities | |
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 14-0027 | OR | Suppliers |
| Y | 282N00000X | General Acute Care Hospital | 14-0027 | OR | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 0033387 | 05 | |
| WA | 1018731 | 05 | |
| OR | 077404 | 05 | |
| OR | 079009 | 05 |
| 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 |
| 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 |
| 1609896174 | Legacy Good Samaritan Hospital and Medical Center | Pharmacy | 1040 Nw 22nd Ave, Suite 100, Portland, OR 97210-3057 | 2006-07-20 |
| 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 |
1015 NW 22ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449629 | Chen-wen Christopher Heh | Psychiatry & Neurology | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2005-10-03 |
| 1023620770 | Jenelle Lynn Stinson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-08-22 |
| 1821618935 | Jena Jobin | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-17 |
| 1164041810 | Danielle Amelie Parker | Occupational Therapist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-13 |
| 1659910362 | Ellen Lee | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-27 |
| 1487291787 | Nicholai Leon Mathewson | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-05 |
| 1528603438 | Lap Huy Nguyen | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-14 |
| 1649814617 | Ethan Andrew Blashford | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-03 |
| 1770127854 | Meri Leah Grotzinger | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-01 |
| 1467095307 | Dennis Thompson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-10-23 |
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447665526 | Linda Damaskos | General Acute Care Hospital | 310 Nw Upyown Terrace, 2a, Portland, OR 97210 | 2014-06-26 |
| 1093132946 | Mercy Hospital | General Acute Care Hospital | 175 Fore River Pkwy, Portland, ME 04102-2779 | 2014-03-27 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 1679879662 | Veterans Hospital | General Acute Care Hospital | 3710 S.w. U.S. Veterans Road, Portland, OR 97239-2964 | 2011-02-08 |
| 1083866933 | Providence St Vincent Hospital | General Acute Care Hospital | 1235 Ne 47th Ave, Suite 285, Portland, OR 97213-2100 | 2008-10-22 |
| 1205024387 | Vetrans Administration | General Acute Care Hospital | 6215 Ne Broadway St, Portland, OR 97213-4713 | 2007-10-14 |
| 1235337551 | Kalei Renae Kadau | General Acute Care Hospital | 1717 Sw Park Ave Apt 813, Portland, OR 97201-3240 | 2007-07-08 |
| 1134242506 | Portland Veterans Affairs Medical Center | General Acute Care Hospital | 5430 Sw Cameron Rd, Portland, OR 97221 | 2007-04-09 |
| 1487788147 | Portland Va Medical Center | General Acute Care Hospital | 5404 Sw Vermont St, Portland, OR 97219-1034 | 2007-03-15 |
| 1457436248 | Kathleen M Hamel | General Acute Care Hospital | 3710 Se Us Veterans Hospital Rd, Portland, OR 97207-9823 | 2006-10-27 |
| 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.