Provider Demographics
NPI:1356545875
Name:UNIVERSITY OF PORTLAND HEALTH CENTER
Entity type:Organization
Organization Name:UNIVERSITY OF PORTLAND HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:HOY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-943-8394
Mailing Address - Street 1:5000 N WILLAMETTE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-5743
Mailing Address - Country:US
Mailing Address - Phone:503-943-7134
Mailing Address - Fax:503-943-7199
Practice Address - Street 1:5000 N WILLAMETTE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-5743
Practice Address - Country:US
Practice Address - Phone:503-943-7134
Practice Address - Fax:503-943-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health