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Contact Information

EAST PORTLAND SURGERY CENTER LLC
9200 SE 91ST AVE
SUITE 100
HAPPY VALLEY, OR97086-3756
 Phone: 503-772-6160
 Fax: 503-772-6161
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulatory Surgical

261QA1903X 49 Ambulatory Surgical Center
Indicates primary specialty

NPI Profile & details for EAST PORTLAND SURGERY CENTER LLC

NPI Number 1417287137
LBN Legal business name EAST PORTLAND SURGERY CENTER LLC
Authorized official ERIC BOON - (MARKET PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/31/2009
Last updated 09/19/2024 - More than a year ago
Identifiers
OR License # 07-1604
OR Medicaid 500624087
OR Other P00864506 RAILROAD MEDICARE
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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