PREMISE HEALTH OF OREGON MEDICAL P C
NPI 1164197083
Clinic/Center - Multi-Specialty in Portland, OR

Active since August 12, 2021
4709 N LAGOON AVE, PORTLAND, OR 97217(503) 745-7138(503) 745-6243 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 2, 2026, Oct 13, 2022, Oct 14, 2021 and 1 more (4 updates tracked since 2021).

About Premise Health Of Oregon Medical P C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMISE HEALTH OF OREGON MEDICAL P C (NPI 1164197083), doing business as Dtna - Portland, is a healthcare organization registered as a multi-specialty in Portland, Oregon and active in the NPI registry since August 2021. The organization lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1164197083
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF OREGON MEDICAL P C
Location Address4709 N LAGOON AVEPortland, OR 97217-7741
Mailing Address5500 Maryland WayBrentwood, TN 37027-7048
Fax(503) 745-6243
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateAugust 12, 2021
Last NPPES UpdateFebruary 2, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
NPI 1164197083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4709 N LAGOON AVE, Portland, OR 97217

Other Names 1

Doing Business AsDtna - Portland

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
4709 N LAGOON AVE, A
PORTLAND, OR 97217
Family Medicine
4709 N LAGOON AVE
PORTLAND, OR 97217

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of Oregon Medical P C's NPI number?

The NPI number for Premise Health Of Oregon Medical P C is 1164197083. It was assigned to this organization in the NPPES registry on August 12, 2021. The provider is doing business as DTNA - Portland.

Where is Premise Health Of Oregon Medical P C located?

Premise Health Of Oregon Medical P C is located at 4709 N Lagoon Ave, Portland, OR 97217. The listed phone number is (503) 745-7138.

What is Premise Health Of Oregon Medical P C's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Premise Health Of Oregon Medical P C was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.