# EAST PORTLAND SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417287137
- **Authorized official:** ERIC BOON (MARKET PRESIDENT)
- **Authorized official phone:** (480) 567-0269

## Contact information

- **Practice address:** 9200 SE 91ST AVE, SUITE 100, HAPPY VALLEY, OR 97086-3756
- **Practice address phone:** (503) 772-6160
- **Practice address fax:** (503) 772-6161
- **Mailing address:** 14201 DALLAS PKWY, DALLAS, TX 75254-2916
- **Mailing address phone:** (469) 893-2500
- **Mailing address fax:** (504) 322-3284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 07-1604 | OR | Yes |

## Other

- **Enumeration date:** 12/31/2009
- **Last updated:** 09/19/2024