Organization
PORTLAND CLINIC
Active
Parent organization
PORTLAND CLINIC
Other names
The Portland Clinic Surgical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PORTLAND CLINIC
Authorized official
MR. DICK CLARK (CEO)
(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) 274-1697
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
10/26/2020
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