ROGER E. ALBERTY, M.D. SURGICAL CENTER – NPI #1508040486
Clinic/Center

ROGER E. ALBERTY, M.D. SURGICAL CENTER is an AHC clinic located in TIGARD, OR. NPPES has assigned the NPI number 1508040486 to ROGER E. ALBERTY, M.D. SURGICAL CENTER on December 27, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ROGER E. ALBERTY, M.D. SURGICAL CENTER” is a dba name, the actual legal business name for this organization is PORTLAND CLINIC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 6 years ago on Oct 26, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ROGER E. ALBERTY, M.D. SURGICAL CENTER below.

NPI Profile for
PORTLAND CLINIC

NPI Number
1508040486
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PORTLAND CLINIC
Doing Business As (dba): ROGER E. ALBERTY, M.D. SURGICAL CENTER
Primary location
9100 SW OLESON ROAD
TIGARD, OR 97223
Phone: (503) 445-9066 Fax:
Mailing address
800 SW 13TH AVE
PORTLAND, OR 97205-1902
Phone: (503) 221-0161 Fax: (503) 221-4451
Organization Subpart
Yes - ROGER E. ALBERTY, M.D. SURGICAL CENTER is subpart of another organization.
Authorized Official
DICK CLARK
CHIEF EXECUTIVE OFFICER
Phone: (503) 221-0161
Updated
Certification Date
Oct 26, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.