PACIFIC VASCULAR SPECIALISTS PC NPI 1164478780

NPI Information

  • NPI: 1164478780
  • Provider Name: PACIFIC VASCULAR SPECIALISTS PC
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • Address: 9155 SW BARNES RD
    STE 321
    PORTLAND, OR
    ZIP 97225
  • Phone: (707) 289-2968

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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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