NPI 1033466206

University Professional Services

Organisation General Practice Physician Portland, OR

Practice location

Address: 4411 SW Vermont St, Portland, OR 97219-1020
Phone: (503) 494-9992
Mailing address: 1400 SW 5th Ave STE 500, Portland, OR 97201-5537

Authorised official

Name: Kelly Smith
Title: Vice President, Erc
Phone: (503) 494-8417

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Oregon →

Registry record

NPI: 1033466206
Entity type: Organization
NPI issued: 7 Aug 2012
Record last updated: 3 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.