EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC NPI 1922304302

NPI Information

NPI: 1922304302
Provider Name: EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC
Classification: Allergy & Immunology - 207KA0200X
Entity Type: Organization

Specialization: Allergy

Address:
2850 SE POWELL BLVD
SUITE 206
GRESHAM, OR
ZIP 97080
Phone: (503) 666-5025
Get Directions

EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC is an allergy allergy immunology in Gresham, OR. The provider is a physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC NPI is 1922304302. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2850 SE POWELL BLVD
SUITE 206
GRESHAM, OR
ZIP 97080-494
Phone: (503) 666-5025
Fax: (503) 666-5795

The provider's authorized official is Austin Underwood Sargent .
The authorized official title is President/owner and has the following contact phone number (503) 666-5025.

The enumeration date for this NPI number is 2/2/2011 and was last updated on 2/2/2011.

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	207KA0200X	Allergy & Immunology	Allergy	MD21072	OREGON	Yes

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
1	151110	MEDICAID	OREGON
2	1011646	MEDICARE PIN	OREGON
3	G71064	MEDICARE UPIN	OREGON

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: 5/5/2024

NPI Synchronization or Removal

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