Organization
OREGON HEALTH & SCIENCE UNIVERSITY
Active
Other names
OHSU Child Development & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY O. JACOBS (PRESIDENT)
(503) 494-8252
Entity
Organization
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-8716
(503) 494-2721
Mailing address
PO BOX 3595, PORTLAND, OR 97208-3595
(503) 494-2709
(503) 494-6868
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033472
—
OR
05
—
1023615
—
WA
05
—
500751932
—
OR
Enumeration date
10/26/2006
Last updated
04/08/2022
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