INTEGRATED MEDICINE GROUP LLC NPI 1033249404

NPI Information

  • NPI: 1033249404
  • Provider Name: INTEGRATED MEDICINE GROUP LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 163 NE 102ND AVE
    BUILDING V
    PORTLAND, OR
    ZIP 97220
  • Phone: (503) 257-3327

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NPI Details

INTEGRATED MEDICINE GROUP LLC is a general practice in Portland, OR. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee INTEGRATED MEDICINE GROUP LLC NPI is 1033249404. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

163 NE 102ND AVE
BUILDING V
PORTLAND, OR
ZIP 97220-169
Phone: (503) 257-3327
Fax: (503) 257-3374

The provider's authorized official is Christy C Heitsch .
The authorized official title is Owner Administrative Director and has the following contact phone number (503) 257-3327.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 2/21/2008.

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
1208D00000XGeneral PracticeOREGONYes

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
1A08050MEDICARE UPINOREGON
2R117633MEDICARE PINOREGON
3DA9368MEDICARE PINOREGON

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: 11/21/2025

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