# EAST PORTLAND SURGICAL CENTER LLC

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

## Provider details

- **NPI number:** 1467484956
- **Authorized official:** MRS. ALVERA M GASKINS (ADMINISTRATOR)
- **Authorized official phone:** (503) 772-6160

## Contact information

- **Practice address:** 9200 SE 91ST AVE, SUITE 100, PORTLAND, OR 97266-6756
- **Practice address phone:** (503) 772-6160
- **Practice address fax:** (503) 772-6161
- **Mailing address:** 9200 SE 91ST AVE, SUITE 100, PORTLAND, OR 97266-6756
- **Mailing address phone:** (503) 772-6160
- **Mailing address fax:** (503) 772-6161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 071572 | OR | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 07/11/2007