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DSH380060C Portland Adventist Medical Center dba Adventist Health Portland (Active)
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Main Details
Name
Portland Adventist Medical Center dba Adventist Health Portland
Subdivision Name
Gresham Station Imaging
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380060C
Medicare Provider Number
380060
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
12/1/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/15/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Portland Adventist Medical Center dba Adventist Health Portland
Jason Panasuk, Finance Officer
(503) 251-6121
Primary Contact
Adventist Health Portland
Rochelle Ford, Clinical Coordinator
(503) 261-6505
Addresses
Street Address
831 NW Council Drive
Suite 100
Gresham, OR 97030
Billing Address
Portland Adventist Medical Center dba Adventist Health Portland
PO Box 16800
Portland, OR 97292
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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