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REVIANCE PORTLAND LLC NPI 1497474993


NPI Information

NPI: 1497474993
Provider Name: REVIANCE PORTLAND, LLC
Classification: Plastic Surgery - 2082S0099X
Entity Type: Organization

Specialization: Plastic Surgery Within the Head and Neck

Address:
9280 SE SUNNYBROOK BLVD STE 301
CLACKAMAS, OR
ZIP 97015
Phone: (503) 953-1230
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REVIANCE PORTLAND, LLC is a plastic surgery within the head and neck plastic surgery in Clackamas, OR. The provider is a plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. REVIANCE PORTLAND, LLC NPI is 1497474993. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9280 SE SUNNYBROOK BLVD STE 301
CLACKAMAS, OR
ZIP 97015-353
Phone: (503) 953-1230

The provider's authorized official is James Chan .
The authorized official title is Owner and has the following contact phone number (503) 953-1230.

The enumeration date for this NPI number is 8/26/2022 and was last updated on 8/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12082S0099XPlastic SurgeryPlastic Surgery Within the Head and NeckYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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