# LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609896174
- **Legal business name:** LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL
- **Authorized official:** SARAH JENSEN (VP FINANCE)
- **Authorized official phone:** (503) 415-5145

## Contact information

- **Practice address:** 1040 NW 22ND AVE, SUITE 100, PORTLAND, OR 97210-3057
- **Practice address phone:** (503) 413-8122
- **Mailing address:** 1040 NW 22ND AVE, SUITE 100, PORTLAND, OR 97210
- **Mailing address phone:** (503) 413-4048
- **Mailing address fax:** (503) 413-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0001427-CS | OR | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 01/20/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3806051 | NCPDP | OR |