Organization
UNIVERSITY PROFESSIONAL SERVICES
Active
Other names
OHSU Health Promotion and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SMITH (VICE PRESIDENT, ERC)
(503) 494-8417
Entity
Organization
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6813
(503) 494-1310
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(503) 494-8417
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/23/2017
Last updated
08/03/2022
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