Portland Dialysis Center

LBN: Portland Peritoneal Center, Inc.
Portland Dialysis Center is an health care organization with primary practice located at 10595 Se Stark St , Portland OR 97216-2747. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Portland Peritoneal Center, Inc. can be contacted via phone (503) 252-0019, or through Green, Jerry via phone (562) 495-8075.

Contact Information

Primary practice address
10595 Se Stark St Portland OR 97216-2747
Phone: (503) 252-0019
Fax: (503) 252-0068
Website:
Map and Directions
Authorized official contact:
Name: Green, Jerry
Phone: (562) 495-8075

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 394020 Oregon

Profile Details

NPI number 1437121704
LBN Legal business name Portland Peritoneal Center, Inc.
DBA Doing business as Portland Dialysis Center
Authorized official Green, Jerry
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437121704 NPPES
Oregon MEDICAID 121231

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