Covered Entity Details

DSH380009FN OREGON HLTH SCIENCE CENTER (Active) - information as of 4/23/2025 10:54:19 PM

Main Details

Name

OREGON HLTH SCIENCE CENTER

Subdivision Name

OHSU Clinics - Radiation Oncology Treatment

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH380009FN

Medicare Provider Number

380009

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/16/2023

Participating Start Date

4/1/2023

Participating Approval Date

2/15/2023

Last Recertification Date

9/6/2024

Contacts

Authorizing Official

OHSU
Joe E Ness, SVP and Chief Operating Officer
(503) 720-7616

Primary Contact

OHSU
Jennifer Zanon, Director Pharmacy Services; Regulatory Compliance
(503) 418-1286

Addresses

Street Address

808 SW Campus Dr Kohler Pavilion
Portland, OR 97239

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
OR	41178	1609824010
WA	1014373
ID	1609824010
AK	H55OP
CA	XHSP42697
MT	1609824010
CO	50828321

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH380009A	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU GABRIEL PARK	4411 SW Vermont st	Portland	OR	Terminated
DSH380009AA	Child	DSH	OREGON HLTH SCIENCE CENTER	Internal Medicine Clinic	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009AB	Child	DSH	OREGON HLTH SCIENCE CENTER	DETU/Immunology Infusion	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009AC	Child	DSH	OREGON HLTH SCIENCE CENTER	Surgery Clinics	3270 SW Sam Jackson Park Rd	Portland	OR	Active
DSH380009AD	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Pain Management Center	3303 SW Bond Ave	Portland	OR	Active
DSH380009AE	Child	DSH	OREGON HLTH SCIENCE CENTER	Clin Neurophysiology	3303 SW Bond	Portland	OR	Active
DSH380009AF	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Cardiac Rehabilitation	3303 SW Bond Ave	Portland	OR	Active
DSH380009AG	Child	DSH	OREGON HLTH SCIENCE CENTER	Ultra Sound Service	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009AH	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Diagnostic Radiology	3303 SW Bond Ave	Portland	OR	Active
DSH380009AJ	Child	DSH	OREGON HLTH SCIENCE CENTER	Ambulatory Surg Mgmnt	3181 SW Sam Jackson Park Rd	Portland	OR	Terminated
DSH380009AK	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Surgery Center	3303 SW Bond	Portland	OR	Active
DSH380009AL	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Short Stay	3303 SW Bond Ave	Portland	OR	Active
DSH380009AM	Child	DSH	OREGON HLTH SCIENCE CENTER	CEI SSU	515 Campus Dr	Portland	OR	Active
DSH380009AN	Child	DSH	OREGON HLTH SCIENCE CENTER	CEI Anesthesia	515 Campus Dr	PORTLAND	OR	Active
DSH380009AP	Child	DSH	OREGON HLTH SCIENCE CENTER	CEI OR	515 SW Campus Dr	Portland	OR	Active
DSH380009AQ	Child	DSH	OREGON HLTH SCIENCE CENTER	Family Medicine Sports Medicine	4411 SW Vermont st	Portland	OR	Active
DSH380009AR	Child	DSH	OREGON HLTH SCIENCE CENTER	Doernbecher Pediatrics Westside (Bethany Village)-Peds Spec- Pul/CF	15220 NW Laidlaw Rd	Portland	OR	Active
DSH380009AS	Child	DSH	OREGON HLTH SCIENCE CENTER	Doernbecher Pediatrics Westside (Bethany Village)-Peds Spec- Urology	15220 NW Laidlaw Rd	Portland	OR	Terminated
DSH380009AT	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Healing (CHH)-Oncology Treatment room	3303 SW Bond Ave	Portland	OR	Terminated
DSH380009AU	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-Plastic Surgery	3303 SW Bond Ave	Portland	OR	Active
DSH380009AV	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-Surgical Oncology	3303 SW Bond Ave	Portland	OR	Active
DSH380009AW	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-CHH Urology	3303 SW Bond Ave	Portland	OR	Active
DSH380009AX	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-CHH Neurosurgery	3303 SW Bond Ave	Portland	OR	Active
DSH380009AY	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-CHH Neurology	3303 SW Bond Ave	Portland	OR	Active
DSH380009AZ	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-Oncology-Multidisciplinary Programs	3303 SW Bond Ave	Portland	OR	Active
DSH380009B	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CENTER FOR HEALTH & HEALING	3303 SW Bond Ave	Portland	OR	Active
DSH380009BA	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-Digestive Health Practice	3303 SW Bond Ave	Portland	OR	Active
DSH380009BB	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing / Dermatology Clinic	3303 SW Bond Ave	Portland	OR	Active
DSH380009BC	Child	DSH	OREGON HLTH SCIENCE CENTER	Center for Health and Healing (CHH)-Dermatology Surgery	3303 SW Bond Ave	Portlnad	OR	Active
DSH380009BD	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH-Adult Eye Clinic	3303 SW Bond	Portland	OR	Active
DSH380009BE	Child	DSH	OREGON HLTH SCIENCE CENTER	Gabriel Park-Medicine Specialty - PV330	4411 SW Vermont st	Portland	OR	Active
DSH380009BF	Child	DSH	OREGON HLTH SCIENCE CENTER	Gabriel Park-Pain Management Center	4411 SW Vermont st	Portland	OR	Active
DSH380009BG	Child	DSH	OREGON HLTH SCIENCE CENTER	Gabriel Park-Orthopedics clinic	4411 SW Vermont st	Portland	OR	Active
DSH380009BH	Child	DSH	OREGON HLTH SCIENCE CENTER	Gabriel Park-Family Medicine Sports Medicine	4411 SW Vermont st	Portland	OR	Terminated
DSH380009BJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Center-Medicine Specialty- PV330	15700 SW Greystone Ct	Beaverton	OR	Active
DSH380009BK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Center-Pain Management Center	15700 SW Greystone Ct	Beaverton	OR	Active
DSH380009BL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Center-CWH Gynecological Oncololgy	15700 SW Greystone Ct	Beaverton	OR	Active
DSH380009BM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Center-Radiation Oncology Beaverton	15700 SW Greystone Ct	Beaverton	OR	Active
DSH380009BN	Child	DSH	OREGON HLTH SCIENCE CENTER	Cornell West-CHH Neurosurgery	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009BP	Child	DSH	OREGON HLTH SCIENCE CENTER	Cornell West- OHSU Orthopedics Clinic	1500 NW Bethany Blvd	Beaverton	OR	Terminated
DSH380009BQ	Child	DSH	OREGON HLTH SCIENCE CENTER	Cornell West-Medicine Specialty-PV340	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009BR	Child	DSH	OREGON HLTH SCIENCE CENTER	Cornell West-Peds Spec- Orthopedics	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009BS	Child	DSH	OREGON HLTH SCIENCE CENTER	Cornell West-OHSU Orthopedics Clinic	18650 NW Cornell Rd Ste 110	Hillsboro	OR	Terminated
DSH380009BT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - DBT Diabetic Bvtn clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009BU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - NEU Comp NEU BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Terminated
DSH380009BV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ORT Ortho OSI BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009BW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ORT Spine BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009BX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD Ultrasound BVTN	15700 SW Greystone ct	BEAVERTON	OR	Active
DSH380009BY	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT Thyroid BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009BZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - CPC PSY BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CA	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT Speech BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - IMC Faculty BVTN	15700 SW Greystone ct	Beaverton	OR	Terminated
DSH380009CC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - NSG Spine BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RHM Faculty BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - REH BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CF	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - FM Faculty BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD MRI BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - SRO Surg Onc BVTN clinic	15700 SW GREYSTONE CT	BEAVERTON	OR	Active
DSH380009CJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Cardiac EKG BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT Facial Recon BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD General BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ORT Faculty BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - DRM MED BVTN clinic	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009CP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - SRO BREAST HEALTH CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - REH PT CHM CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD MAMMO CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT LARYNGOLOGY CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT GEN RESIDENTS CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT SPEACH CHH2	3303 SW BOND AVE	PORTLAND	OR	Active
DSH380009CV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - ENT THYROID CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - END THYROID CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - CAR CARD CATH LAB CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CY	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - CAR CARD CATH ARR CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009CZ	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH2 ENT HEAD NECK	3303 SW Bond Ave	Portland	OR	Active
DSH380009D	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU DOERNBECHER CHILDRENS HOSPITAL	700 SW Campus dr	Portland	OR	Active
DSH380009DA	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD GEN CORNELL WEST	1500 NW Bethany Blvd	BEAVERTON	OR	Terminated
DSH380009DB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - RAD ULTRASOUND CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - MSPU CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - DRM MULTID MEL CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - SRO BREAST CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DF	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - CHM FACULTY CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Ped Echo CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009DH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - PED ENDOCRINOLOGY CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009DJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OREGON HEALTH & SCIENCE UNIVERSITY - REH PT VASC PPV	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009DK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Ped Cardiology CW	1500 NW Bethany Blvd	BEAVERTON	OR	Active
DSH380009DL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Ped Neurology CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009DM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Ped Gastro CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009DN	Child	DSH	OREGON HLTH SCIENCE CENTER	OREGON HEALTH & SCIENCE UNIVERSITY - IMC HRBR CLINIC PPV	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009DP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - PED Nephrology	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009DQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - REH OT CHM CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Ped Pulmonary CW	1500 NW Bethany Blvd	BEAVERTON	OR	Active
DSH380009DS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - PCG IMMEDIATECARE BVTN	15700 SW Greystone ct	Beaverton	OR	Active
DSH380009DT	Child	DSH	OREGON HLTH SCIENCE CENTER	OREGON HEALTH & SCIENCE UNIVERSITY - NHT TRANS MED PPV 4	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009DU	Child	DSH	OREGON HLTH SCIENCE CENTER	OREGON HEALTH & SCIENCE UNIVERSITY - IDC WOUND 4 PPV	3270 SW PAVILION LOOP	PORTLAND	OR	Active
DSH380009DV	Child	DSH	OREGON HLTH SCIENCE CENTER	OREGON HEALTH & SCIENCE UNIVERSITY - NSG PEDS SPINE CHH1	3303 S BOND AVE	PORTLAND	OR	Active
DSH380009DW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - PMC PREOP ANEMIA MGMT	3303 SW Bond Ave	Portland	OR	Active
DSH380009DX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - IRC BODYINTERVENT CHH2	3303 SW Bond Ave	Portland	OR	Active
DSH380009DY	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY DCH - ENT PEDIATRICS PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Active
DSH380009DZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH FACULTY HOSP KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Terminated
DSH380009E	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Casey Eye Institute	515 SW Campus Dr	Portland	OR	Active
DSH380009EA	Child	DSH	OREGON HLTH SCIENCE CENTER	CTRC HRC - CTRC INFUSION 10D HRC	3250 SW Sam Jackson Park Rd Hatfield Research Center 10D	Portland	OR	Active
DSH380009EB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU GASTROENTEROLOGY MPV - GAS ENDO MPV	3161 SW Pavilion Loop Multnomah Pavilion, 4th floor	Portland	OR	Active
DSH380009EC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY PPV - ENT THYROID PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Active
DSH380009ED	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY PPV - ENT HEAD NECK PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Active
DSH380009EE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU DCH - SEDATION PEDS	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009EF	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI INTRA OP LOC	515 SW Campus Dr	Portland	OR	Active
DSH380009EG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH INTEGRATE KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009EH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH UROGYN KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Terminated
DSH380009EJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Dermatology PPV - DRM MED RHEUM PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th floor	Portland	OR	Terminated
DSH380009EK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RHEUMATOLOGY PPV - RHM INFUSION 4 PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th Floor	Portland	OR	Terminated
DSH380009EL	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI SHORT STAY	515 SW Campus Dr Casey Eye Institute	Portland	OR	Terminated
DSH380009EM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY DCH - ENT PEDIATRICS DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009EN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Pediatrics DCH - PED ENDO HEM ONC DCH	700 Campus Dr 10th floor	Portland	OR	Active
DSH380009EP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY PPV - ENT ADULT PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Terminated
DSH380009EQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RHEUMATOLOGY PPV - RHM US INJ 4 PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th Floor	Portland	OR	Active
DSH380009ER	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RHEUMATOLOGY PPV - RHM FIBROMYALGIA 4 PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th floor	Portland	OR	Active
DSH380009ES	Child	DSH	OREGON HLTH SCIENCE CENTER	EMERGENCY - EMERGENCY DEPT HRC	3250 SW Sam Jackson Park Rd OHSU Hospital	Portland	OR	Active
DSH380009ET	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH UROLOGY KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009EU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH PRIMARY CARE KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009EV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH PROCEDURE KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009EW	Child	DSH	OREGON HLTH SCIENCE CENTER	DCH OR SERVICES - DCH 8S PEDS DAY HOSP	700 SW Campus Dr 8S-8311/DC8S DCH	Portland	OR	Active
DSH380009EX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU OTOLARYNGOLOGY DCH - ENT CRANIOFAC DIS DCH	700 SW Campus Dr Doernbecher Children's Hospital	Portland	OR	Active
DSH380009EY	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI OCULAR ONCOLOGY	515 SW Campus Dr Casey Eye Institute, 5th floor	Portland	OR	Active
DSH380009EZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH GYN ONC KPV	3303 S Bond Ave Center for Health and Healing, Building 2	Portland	OR	Active
DSH380009F	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PHYSICIAN'S PAVILION	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009FA	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI GENETICS	515 SW Campus Dr Casey Eye Institute, 5th floor	Portland	OR	Active
DSH380009FB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Pediatrics DCH - PED INFUSION DCH	700 Campus Dr 10th floor	Portland	OR	Active
DSH380009FC	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI OCULOPLASTICS	515 SW Campus Dr , 5th floor	Portland	OR	Active
DSH380009FD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CWH - CWH GENERALISTS KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009FE	Child	DSH	OREGON HLTH SCIENCE CENTER	Wound Care - Wound Care PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th Floor	Portland	OR	Active
DSH380009FF	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI UVEITIS	515 SW Campus Dr Casey Eye Institute, 4th floor	Portland	OR	Active
DSH380009FG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RHEUMATOLOGY PPV - RHM LUP/SCL 4 PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th Floor	Portland	OR	Terminated
DSH380009FH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU DCH - Peds specialty plastic surgery	700 SW Campus dr	Portland	OR	Active
DSH380009FJ	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH1 Clinics - Vaccination clinic	3303 SW Bond Ave	Portland	OR	Active
DSH380009FK	Child	DSH	OREGON HLTH SCIENCE CENTER	Rad Nuc Med - Nuclear Med SJH	3245 SW pavilion Loop SJH	Portland	OR	Active
DSH380009FL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE Metabolic DCH	700 SW Campus Dr, 7th floor	Portland	OR	Active
DSH380009FM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - Radiation Oncology Procedures	808 SW Campus Dr Kohler Pavilion	Portland	OR	Active
DSH380009FN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - Radiation Oncology Treatment	808 SW Campus Dr Kohler Pavilion	Portland	OR	Active
DSH380009FP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU clnics - Radiation Oncology RAD medicine	808 SW Campus Dr Kohler Pavilion	Portland	OR	Active
DSH380009FQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - ENT OTOLOGY PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Active
DSH380009FR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD PET BVTN	15700 SW Greystone Ct OHSU Beaverton Clinic	Beaverton	OR	Active
DSH380009FS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE GENETICS DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009FT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CARDIOLOGY - CAR ECHO CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009FU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - END GENERAL PPV	3270 SW Pavilion Loop Physician's Pavilion, 2nd floor	Portland	OR	Active
DSH380009FV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU NEUROLOGY - NEU MVMNT DISORDER CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009FW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED PULMONARY DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009FX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU NEUROLOGY - NEU HEADACHE CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009FY	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU LABOR AND DELIVERY - PED FETAL SPEC KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009FZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED CYSTICFIBROSIS DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009G	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU KNIGHT CANCER INSTITUTE-BEAVERTON HEMATOLOGY ONCOLOGY	15700 SW GREYSTONE COURT	BEAVERTON	OR	Active
DSH380009GA	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD MRI DCH	700 SW Campus Dr, 7th floor	Portland	OR	Active
DSH380009GB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PS SURG DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD GENERAL ED HRC	3250 SW Sam Jackson Park Rd Hatfield Research Center	Portland	OR	Active
DSH380009GD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD PETMR LBRB	3215 SW Pavilion Loop	Portland	OR	Active
DSH380009GE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED NEUROLOGY DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GF	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED HEM ONC CLINIC DCH	700 SW Campus Dr Doernbecher Children's Hospital, 10th floor	Portland	OR	Active
DSH380009GG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PNC MULTID MFM CAR KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009GH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - IMC RESIDENTS GERI PPV	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009GJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - ENT MULTID FACIAL CEI	515 SW Campus Dr , 5th floor	Portland	OR	Active
DSH380009GK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Radiology - RAD NUC MED CHH1	3303 SW Bond Ave Building 1	Portland	OR	Active
DSH380009GL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CARDIOLOGY - CAR ECHO BVTN	15700 SW Greystone Ct OHSU Beaverton Clinic	Beaverton	OR	Active
DSH380009GM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD PET KPV	808 SW Campus Dr Kohler Pavilion	Portland	OR	Active
DSH380009GN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - CDR NEURO DEVEL	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD CT SCAN CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009GQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - NEU EPILEPSY HRC	3250 SW Sam Jackson Park Rd Hatfield Research Center, 13th floor	Portland	OR	Active
DSH380009GR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - URO PEDS 7 DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE METABOLIC DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Terminated
DSH380009GT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED CAMPUS PEDS DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PNC PERINATOLOGY PPV	3270 SW Pavilion Loop Physician's Pavilion, 4th floor	Portland	OR	Active
DSH380009GV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - CDR HEMO HEM ONC DCH	700 SW Campus Dr Doernbecher Children's Hospital, 10th floor	Portland	OR	Active
DSH380009GW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD GENERAL DCH	700 SW Campus Dr, 7th floor	Portland	OR	Active
DSH380009GX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS DCH - PED ADOLESCENTHLTH DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009GY	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI RETINA ECEC	545 SW Campus Dr Elks Children's Eye Clinic, 4th floor	Portland	OR	Active
DSH380009GZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED NEPHROLOGY DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009H	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU KNIGHT CANCER INSTITUTE- NW HEMATOLOGY ONCOLOGY	1130 NW 22ND AVE	PORTLAND	OR	Active
DSH380009HA	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE PEDS GENETICS DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED GASTRO DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - NEU AGING/ALZ CHH1	3303 SW Bond Ave Building 1	Portland	OR	Active
DSH380009HD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - NMW MIDWIFERY KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009HE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - CWH GENERALISTS CHH1	3303 S Bond Ave Center for Health and Healing, Building 1, 11th Floor	Portland	OR	Active
DSH380009HF	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - IMC CLIN SUPPORT PPV	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009HG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED RENAL TX DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU NEUROLOGY - NEU NEUROMUSC CHH1	3303 S Bond Ave Center for Health and Healing, Building 1, 11th Floor	Portland	OR	Active
DSH380009HJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED NEU HEM ONC DCH	700 SW Campus Dr Doernbecher Children's Hospital, 10th floor	Portland	OR	Active
DSH380009HK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD INTERVENTION CHH2	3303 S Bond Ave Center for Health and Healing, Building 2	Portland	OR	Active
DSH380009HL	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PNC PERINATOLOGY KPV	808 SW Campus Dr Kohler Pavilion, 7th floor	Portland	OR	Active
DSH380009HM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CARDIOLOGY - CAR ECHO SJH	3245 SW Pavilion Loop - SJH	Portland	OR	Active
DSH380009HN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED ORTHO DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE PEDS NEURO DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED SPEC PROC RM DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU RADIOLOGY - RAD GENERAL 3 CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009HS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - PCG IMMEDIATECARE	3303 SW Bond Ave Building 1	Portland	OR	Active
DSH380009HT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - DBD Diabetic Center Ped PPV	3270 SW Pavilion Loop	Portland	OR	Terminated
DSH380009HU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - CDR SPINA BIFIDA	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - NEU MS CENTER CHH1	3303 SW Bond Ave Building 1	Portland	OR	Active
DSH380009HW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED HLTHYLIFESTYLE CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009HX	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED ENDOCRINOLOGY DCH	700 SW Campus Dr Doernbecher Children's Hospital, 7th floor	Portland	OR	Active
DSH380009HY	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS - PED ADOLESCENTHLTH CW	1500 NW Bethany Blvd	Beaverton	OR	Active
DSH380009HZ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - IMC RES PCE PPV	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009I	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Institute - Tualatin Hematology Oncology	19260 SW 65TH AVENUE	TUALATIN	OR	Active
DSH380009J	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Institute - Gresham Hematology Oncology	24988 SE STARK ST	GRESHAM	OR	Active
DSH380009JA	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - Out Patient Care Unit -OCU	3303 S Bond Ave Center for Health and Healing, Building 2	Portland	OR	Active
DSH380009JB	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - CAR BARIATRIC SURG CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009JC	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics - Bariatric Surg CHH2	3303 S Bond Ave Center for Health and Healing, Building 2	Portland	OR	Active
DSH380009JD	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE MULTD CANCER CHH2	3303 S Bond Ave Center for Health and Healing, Building 2	Portland	OR	Active
DSH380009JE	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU MGE clinics - MGE GENETICS NEU CHH1	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009JF	Child	DSH	OREGON HLTH SCIENCE CENTER	Casey Eye Institute - CEI Pediatric clinic	545 SW Campus Dr Elks Children's Eye Clinic	Portland	OR	Active
DSH380009JG	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Pediatric Specialty	1500 NW BETHANY BLVD	BEAVERTON	OR	Active
DSH380009JH	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU PEDIATRICS DCH - Pediatric Specialty	700 SW Campus Dr	Portland	OR	Active
DSH380009JJ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Gastro CHH	3303 S BOND AVE	PORTLAND	OR	Active
DSH380009JK	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU HOSPITALS & CLINICS - Urology	10000 SE MAIN ST	PORTLAND	OR	Active
DSH380009JL	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Clinics OR Services - University Fertility Consultants	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009JM	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU CLINICS HRC - Nuclear Med HRC	3250 SW Sam Jackson Park Rd	Portland	OR	Active
DSH380009JN	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinic ORTHO AHPL - ORT FACULTY AHPL	10000 SE Main st Adventist Pavilion	Portland	OR	Active
DSH380009JP	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics Respiratory - Respiratory Therapy PPV	3270 SW Pavillion Loop	Portland	OR	Active
DSH380009JQ	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics MPV - Respiratory Therapy MPV	3161 SW Pavilion Loop	Portland	OR	Active
DSH380009JR	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics Cardio CHH1 - CAR ACHD NW GAAP	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009JS	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU DCH CLINICS - DRM PEDS DCH	700 SW Campus Dr	Portland	OR	Active
DSH380009JT	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics CHH 1 - HPL Human Performance Lab	3303 S Bond Ave Center for Health and Healing, Building 1	Portland	OR	Active
DSH380009JU	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics Doernbecher - Child Psych clinic DCH	700 SW Campus Dr	Portland	OR	Active
DSH380009JV	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics PPV - IDC Infect Dis 2	3270 SW Pavillion Loop PPV	Portland	OR	Active
DSH380009JW	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Clinics PPV - IDC Infect Dis 3	3270 SW Pavillion Loop PPV	Portland	OR	Active
DSH380009L	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Knight Cancer Institute - E Portland Hematology Oncology	10000 SE MAIN STREET	PORTLAND	OR	Active
DSH380009N	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Doernbecher Pediatrics Westside	15220 NW Laidlaw Rd	Portland	OR	Active
DSH380009P	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Dermatology Practice	16699 SW Boones Ferry Road, Suite 210	Lake Oswego	OR	Active
DSH380009Q	Child	DSH	OREGON HLTH SCIENCE CENTER	Psychiatric Clinic	3245 SW Pavilion Loop - SJH	Portland	OR	Active
DSH380009R	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH ENT clinic	3303 SW Bond	Portland	OR	Active
DSH380009S	Child	DSH	OREGON HLTH SCIENCE CENTER	ENT Clinic	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009T	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Family medicine at Gabriel Park	4411 SW Vermont st	Portland	OR	Active
DSH380009U	Child	DSH	OREGON HLTH SCIENCE CENTER	Medicine Spec- AC Clinic	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009V	Child	DSH	OREGON HLTH SCIENCE CENTER	Diabetes Health Center	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009W	Child	DSH	OREGON HLTH SCIENCE CENTER	Voice Clinic	3303 SW Bond	Portland	OR	Active
DSH380009X	Child	DSH	OREGON HLTH SCIENCE CENTER	OHSU Family Medicine at CHH South Waterfront	3303 SW Bond Ave	Portland	OR	Active
DSH380009Y	Child	DSH	OREGON HLTH SCIENCE CENTER	PPV Immunology Infusion unit	3270 SW Pavilion Loop	Portland	OR	Active
DSH380009Z	Child	DSH	OREGON HLTH SCIENCE CENTER	CHH Oncology Treatment Rm	3303 SW Bond Ave	Portland	OR	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/6/2024 10:08 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1609824010	9/6/2024 10:08 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		MT	9/6/2024 10:08 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/6/2024 10:08 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		50828321	9/6/2024 10:08 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		CO	9/6/2024 10:08 AM
Details	Last Recertification Date	Update	Recertification	8/21/2023 11:51:14 AM	9/6/2024 10:08:03 AM	9/6/2024 10:08 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1609824010	10/16/2023 3:16 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		OR	10/16/2023 3:16 PM
Details	Last Recertification Date	Update	Recertification		8/21/2023 11:51:14 AM	8/21/2023 11:51 AM
Details	State	Update		Approved	Active	4/1/2023 12:01 AM
Addresses	Main Address	Insert	New Registration		808 SW Campus Dr Kohler Pavilion Portland, OR 97239	2/15/2023 10:27 AM
Contacts	Signed By	Insert	New Registration		Ness, Joe E SVP and Chief Operating Officer OHSU 5037207616	2/15/2023 10:27 AM
Details	340B ID	Update	New Registration		DSH380009FN	2/15/2023 10:27 AM
Details	Entity Name	Update	New Registration	OHSU HOSPITAL AND CLINICS	OREGON HLTH SCIENCE CENTER	2/15/2023 10:27 AM
Details	Entity Subname	Update	New Registration	OHSU Clinics	OHSU Clinics - Radiation Oncology Treatment	2/15/2023 10:27 AM
Dates	Participating Approval Date	Update	New Registration		2/15/2023 10:27:50 AM	2/15/2023 10:27 AM
Details	State	Update	New Registration	Pending	Approved	2/15/2023 10:27 AM
Dates	Signed By Date	Update	New Registration		2/15/2023 10:03:09 AM	2/15/2023 10:27 AM
Dates	Start Date	Update	New Registration		4/1/2023 12:00:00 AM	2/15/2023 10:27 AM
Addresses	Main Address	Insert	New Registration		808 SW Campus Dr Kohler Pavilion Portland, OR 97239	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		41178	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		OR	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1014373	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		WA	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1609824010	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		ID	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		H55OP	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		AK	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		XHSP42697	1/16/2023 3:39 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		CA	1/16/2023 3:39 PM
Contacts	Primary Contact	Insert	New Registration		Zanon, Jennifer Director Pharmacy Services; Regulatory Compliance OHSU 5034181286	1/16/2023 3:39 PM
Contacts	Authorizing Official	Insert	New Registration		Ness, Joe E SVP and Chief Operating Officer OHSU 5037207616	1/16/2023 3:39 PM
Details	Assistance Received From Date	Insert	New Registration			1/16/2023 3:39 PM
Details	Assistance Received To Date	Insert	New Registration			1/16/2023 3:39 PM
Details	Last Recertification Date	Insert	New Registration			1/16/2023 3:39 PM
Details	Grant Number	Insert	New Registration			1/16/2023 3:39 PM
Details	340B ID	Insert	New Registration			1/16/2023 3:39 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/16/2023 3:39 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/16/2023 3:39 PM
Details	Medicare Provider Number	Insert	New Registration		380009	1/16/2023 3:39 PM
Details	Entity Name	Insert	New Registration		OHSU HOSPITAL AND CLINICS	1/16/2023 3:39 PM
Details	NOFO Number	Insert	New Registration			1/16/2023 3:39 PM
Details	Program Code	Insert	New Registration		DSH	1/16/2023 3:39 PM
Details	Entity Subname	Insert	New Registration		OHSU Clinics	1/16/2023 3:39 PM
Dates	Participating Approval Date	Insert	New Registration			1/16/2023 3:39 PM
Details	State	Insert	New Registration		Pending	1/16/2023 3:39 PM
Dates	Registration Date	Insert	New Registration		1/16/2023 3:39:16 PM	1/16/2023 3:39 PM
Dates	Signed By Date	Insert	New Registration			1/16/2023 3:39 PM
Dates	Start Date	Insert	New Registration			1/16/2023 3:39 PM
Terminations	Termination Comments	Insert	New Registration			1/16/2023 3:39 PM
Terminations	Termination Date	Insert	New Registration			1/16/2023 3:39 PM
Terminations	Termination Effective Date	Insert	New Registration			1/16/2023 3:39 PM
Terminations	Termination Reason	Insert	New Registration			1/16/2023 3:39 PM