1316354970 NPI number — UNIVERSITY PROFESSIONAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316354970 NPI number — UNIVERSITY PROFESSIONAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY PROFESSIONAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316354970
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 SW 5TH AVE STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97201-5539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-617-6855
Provider Business Mailing Address Fax Number:
503-346-8015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 SW FIRST AVE STE 1215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97201-4753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-494-4745
Provider Business Practice Location Address Fax Number:
503-494-4747
Provider Enumeration Date:
07/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
VP/ENTERPRISE REVENUE CYCLE
Authorized Official Telephone Number:
503-494-4422

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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