Organization
PORTLAND VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TELL LCSW (CLINIC MANAGER)
(503) 220-8262
Entity
Organization
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
(503) 721-1047
Mailing address
15660 SW WINTERGREEN ST, TIGARD, OR 97223-2617
(503) 220-8262
(503) 721-1047
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
4833942-3501
UT
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
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