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PORTLAND DIABETES & ENDOCRINOLOGY CENTER P C NPI 1942419569


NPI Information

NPI: 1942419569
Provider Name: PORTLAND DIABETES & ENDOCRINOLOGY CENTER, P C
Classification: Internal Medicine - 207RE0101X
Entity Type: Organization

Specialization: Endocrinology, Diabetes & Metabolism

CLIA Number: 38D2043330

Address:
9135 SW BARNES RD STE 985
PORTLAND, OR
ZIP 97225
Phone: (503) 297-3336
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PORTLAND DIABETES & ENDOCRINOLOGY CENTER, P C is an endocrinology and diabetes and metabolism internal medicine in Portland, OR. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. PORTLAND DIABETES & ENDOCRINOLOGY CENTER, P C NPI is 1942419569. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9135 SW BARNES RD STE 985
PORTLAND, OR
ZIP 97225-699
Phone: (503) 297-3336
Fax: (503) 297-3338

The provider's authorized official is Richard W Bergstrom .
The authorized official title is President and has the following contact phone number (503) 274-4884.

The CLIA number assigned to this NPI record is 38D2043330 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 10/14/2022.


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
1207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismOREGONYes

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
1151316MEDICAIDOREGON

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

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