Provider Demographics
NPI:1376086694
Name:OREGON RHEUMATOLOGY CLINICS, LLC
Entity Type:Organization
Organization Name:OREGON RHEUMATOLOGY CLINICS, LLC
Other - Org Name:HILLSBORO RHEUMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MACALESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:971-228-8855
Mailing Address - Street 1:545 SE OAK ST STE F
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4147
Mailing Address - Country:US
Mailing Address - Phone:971-228-8855
Mailing Address - Fax:503-206-0118
Practice Address - Street 1:545 SE OAK ST
Practice Address - Street 2:SUITE F
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4147
Practice Address - Country:US
Practice Address - Phone:503-754-3676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO157657207RR0500X
332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR2940143Medicaid
OH2940143Medicaid