# SURGERY CENTER AT ST. VINCENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** East Pavilion Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316449168
- **Authorized official:** MR. BRUCE DUDLEY (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (971) 339-7791

## Contact information

- **Practice address:** 9135 SW BARNES RD STE 161, PORTLAND, OR 97225
- **Practice address phone:** (971) 339-7791
- **Mailing address:** 9135 SW BARNES RD STE 161, PORTLAND, OR 97225-6646
- **Mailing address phone:** (971) 339-7791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2018
- **Last updated:** 07/16/2019