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Contact Information

REVIANCE PORTLAND, LLC
9280 SE SUNNYBROOK BLVD STE 301
CLACKAMAS, OR97015-9353
 Phone: 503-953-1230
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for REVIANCE PORTLAND, LLC

NPI Number 1497474993
LBN Legal business name REVIANCE PORTLAND, LLC
Authorized official JAMES CHAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/26/2022
Last updated 08/26/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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