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REVIANCE PORTLAND, LLC
NPI 1497474993
Plastic Surgery - Plastic Surgery Within the Head and Neck in Clackamas, OR

Active since August 26, 2022CLIA 38D2319413 · Waiver
9280 SE SUNNYBROOK BLVD STE 301, CLACKAMAS, OR 97015(503) 953-1230 Get Directions Write a Review

NPPES record last updated: August 26, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Reviance Portland, Llc NPPES

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

REVIANCE PORTLAND, LLC (NPI 1497474993) is a healthcare organization registered as a plastic surgery within the head and neck in Clackamas, Oregon and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through February 26, 2027 and lists James Chan, Owner, as its authorized official.

NPPES Registry Identity

NPI1497474993
Entity TypeOrganization
Primary Taxonomy2082S0099X
Legal Business NameREVIANCE PORTLAND, LLC
Location Address9280 SE SUNNYBROOK BLVD STE 301Clackamas, OR 97015-9353
Mailing Address9280 Se Sunnybrook Blvd Ste 301Clackamas, OR 97015-9353 · (503) 953-1230
Phone(503) 953-1230
Organization SubpartNo
Authorized OfficialJames ChanOwner · (503) 953-1230
Enumeration DateAugust 26, 2022
NPPES CertifiedAugust 25, 2022
✔ NPI 1497474993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic Surgery · Plastic Surgery Within the Head and NeckAllopathic & Osteopathic Physicians
Taxonomy Code2082S0099X
Definition
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.
9280 SE SUNNYBROOK BLVD STE 301, Clackamas, OR 97015
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2319413

Reviance Portland, LLC · Clackamas, OR
Active · expires Feb 26, 2027
CLIA Number38D2319413
Laboratory TypePhysician Office
Certificate Effective DateFebruary 27, 2025
Certificate Expiration DateFebruary 26, 2027
Laboratory DirectorJames Chan
Laboratory Phone(503) 953-1230
Laboratory LocationReviance Portland, LLC9200 SE Sunnybrook Blvd Suite 200, Clackamas, OR 97015
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Reviance Portland, LLC's NPI number?

The NPI number for Reviance Portland, LLC is 1497474993. It was assigned to this organization in the NPPES registry on August 26, 2022.

Where is Reviance Portland, LLC located?

Reviance Portland, LLC is located at 9280 SE Sunnybrook Blvd Ste 301, Clackamas, OR 97015. The listed phone number is (503) 953-1230.

What is Reviance Portland, LLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery, specializing in Plastic Surgery Within the Head and Neck, with taxonomy code 2082S0099X.

Does Reviance Portland, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2319413) is associated with this NPI, valid through February 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Reviance Portland, LLC was last updated on August 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.