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DSH380060E 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
Hyperbaric Oxygen Therapy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380060E
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
10201 SE Main Street
Suite 9
Portland, OR 97216
Billing Address
Portland Adventist Medical Center dba Adventist Health Portland
PO Box 16800
Portland, OR 97292
Comments
Medicaid Billing
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