WILSHIRE SURGERY CENTER LLC NPI 1417278011

NPI Information

NPI: 1417278011
Provider Name: WILSHIRE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 38D2007105

Address:
9775 SW WILSHIRE ST
SUITE 250
PORTLAND, OR
ZIP 97225
Phone: (503) 688-5187
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WILSHIRE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Portland, OR. WILSHIRE SURGERY CENTER, LLC NPI is 1417278011. The provider is registered as an organization entity type.

The provider's business location address is:

9775 SW WILSHIRE ST
SUITE 250
PORTLAND, OR
ZIP 97225-020
Phone: (503) 688-5187
Fax: (503) 688-5199

The provider's authorized official is Stephanie D Fatheree .
The authorized official title is Revenue /credentialing Specialist and has the following contact phone number (503) 688-5187.

The CLIA number assigned to this NPI record is 38D2007105 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2010 and was last updated on 10/18/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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

NPI Synchronization or Removal

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