Organization
UNIVERSITY PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANNE SMITH (VP/ENTERPRISE REVENUE CYCLE)
(503) 494-4422
Entity
Organization
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276228
—
OR
Enumeration date
08/06/2008
Last updated
09/12/2025
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