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PACIFIC VASCULAR SPECIALISTS PC NPI 1164478780


NPI Information

NPI: 1164478780
Provider Name: PACIFIC VASCULAR SPECIALISTS PC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
9155 SW BARNES RD
STE 321
PORTLAND, OR
ZIP 97225
Phone: (707) 289-2968
Get Directions

PACIFIC VASCULAR SPECIALISTS PC is a vascular surgery surgery in Portland, OR. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PACIFIC VASCULAR SPECIALISTS PC NPI is 1164478780. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9155 SW BARNES RD
STE 321
PORTLAND, OR
ZIP 97225
Phone: (707) 289-2968
Fax: (503) 719-8253

The provider's authorized official is John W Wiest .
The authorized official title is Owner and has the following contact phone number (707) 289-2968.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 5/4/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular SurgeryMD14474OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1278874MEDICAIDOREGON
2R109778OTHEROREGONPTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.