SURGICAL SPECIALTY GROUP PC NPI 1902978984

NPI Information

  • NPI: 1902978984
  • Provider Name: SURGICAL SPECIALTY GROUP PC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Doing Business As: THE COLON & RECTAL CLINIC
  • Address: 511 SW 10TH AVENUE
    SUITE 714
    PORTLAND, OR
    ZIP 97205
  • Phone: (503) 222-1615

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NPI Details

SURGICAL SPECIALTY GROUP PC is a medical specialty clinic center in Portland, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). SURGICAL SPECIALTY GROUP PC NPI is 1902978984. The provider is registered as an organization entity type.
The provider Is Doing Business As The Colon & Rectal Clinic.

The provider's business location address is:

511 SW 10TH AVENUE
SUITE 714
PORTLAND, OR
ZIP 97205-708
Phone: (503) 222-1615
Fax: (503) 222-0016

The provider's authorized official is Olga Maria Veis .
The authorized official title is Clinic Manager and has the following contact phone number (503) 222-1615.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 11/5/2013.

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
1261QM2500XClinic/CenterMedical SpecialtyYes

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
1084061MEDICAIDOREGON
20000WCHWVMEDICARE 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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