Organization · Type 2 NPI

Providence Health & Services - Oregon

Sports Medicine (Internal Medicine) Physician · Portland, OR

NPI number 1235479643 Active

Practice location

909 SW 18th Ave
Portland, OR 97205-1705

Fax (503) 962-1925

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000XNone listed
Sports Medicine (Internal Medicine) Physician Primary 207RS0010XNone listed
Clinic/Center 261Q00000XNone listed

Sports Medicine (Internal Medicine) Physician: An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psycho…

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About NPI 1235479643

Providence Health & Services - Oregon's National Provider Identifier is 1235479643, issued on Feb 21, 2013. The primary taxonomy on file is Sports Medicine (Internal Medicine) Physician (207RS0010X), and the practice location is in Portland, OR. The record was last updated on Jul 4, 2025.