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Organization
PORTLAND CLINIC
Active
Organization
PORTLAND CLINIC
Active
Other names
The Portland Clinic LLP
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L MULCASTER DO (CMO)
(503) 221-0161
Entity
Organization
Contact information
Practice address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 221-4451
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 221-4451
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
08/03/2006
Last updated
04/30/2024
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