Provider Demographics
NPI:1437385036
Name:OREGON HEALTH AND SCIENCE UNIVERSITY
Entity Type:Organization
Organization Name:OREGON HEALTH AND SCIENCE UNIVERSITY
Other - Org Name:OHSU INTERCULTURAL PSYCHIATRIC PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-494-8252
Mailing Address - Street 1:3633 SE 35TH PL
Mailing Address - Street 2:ATTN: LIZ STEVENSON
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3365
Mailing Address - Country:US
Mailing Address - Phone:503-494-4222
Mailing Address - Fax:503-494-6143
Practice Address - Street 1:3633 SE 35TH PL
Practice Address - Street 2:ATTN: LIZ STEVENSON
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3365
Practice Address - Country:US
Practice Address - Phone:503-494-4222
Practice Address - Fax:503-494-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health