BEAVERTON WEIGHT LOSS & FAMILY PRACTICE NPI 1902013725

NPI Information

NPI: 1902013725
Provider Name: BEAVERTON WEIGHT LOSS & FAMILY PRACTICE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 38D0987219

Address:
13292 SW 161ST PL
TIGARD, OR
ZIP 97223
Phone: (503) 330-7025
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BEAVERTON WEIGHT LOSS & FAMILY PRACTICE is a primary care clinic center in Tigard, OR. BEAVERTON WEIGHT LOSS & FAMILY PRACTICE NPI is 1902013725. The provider is registered as an organization entity type.

The provider's business location address is:

13292 SW 161ST PL
TIGARD, OR
ZIP 97223-677
Phone: (503) 330-7025

The provider's authorized official is Joseph Edward Knaus .
The authorized official title is Owner and has the following contact phone number (503) 330-7025.

The CLIA number assigned to this NPI record is 38D0987219 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/17/2007 and was last updated on 6/22/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	99007644	OREGON	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P28798	MEDICARE UPIN	OREGON
2	110388	MEDICARE ID-TYPE UNSPECIFIED	OREGON	BVTN WT LOSS & FAM PRACT
3	130247	MEDICARE ID-TYPE UNSPECIFIED	OREGON	PAIN MGMT CONSULTANTS

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: 5/5/2024

NPI Synchronization or Removal

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