OrganizationActive
The Golden Room LLC
NPI 1205172913 · Specialist · Portland, OR
The Golden Room LLC is a Specialist organization in Portland, OR (NPI 1205172913).
Provider details
- NPI number
- 1205172913
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Mauri Mckitrick, Owner/Lmt(971) 506-4560
- License
- 8161 (OR)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
636 Se 49th Ave
Portland, OR 97215-1728
Phone: (971) 506-4560
Street-level locationGet directions
Mailing address
4360 Ne Simpson St
Portland, OR 97218-1444
Registry dates
- Enumerated
- 2012-12-27
- Last updated
- 2012-12-27
Frequently asked questions
- What is The Golden Room LLC's NPI number?
- The Golden Room LLC's National Provider Identifier (NPI) is 1205172913, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is The Golden Room LLC?
- The Golden Room LLC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is The Golden Room LLC located?
- The Golden Room LLC's practice location on file with NPPES is 636 Se 49th Ave, Portland, OR 97215-1728.
- What is The Golden Room LLC's phone number?
- The practice phone number listed in the NPPES registry for The Golden Room LLC is (971) 506-4560.
- Who is the authorized official for The Golden Room LLC?
- The authorized official listed on The Golden Room LLC's NPPES record is Mauri Mckitrick, Owner/Lmt. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is The Golden Room LLC's NPI active?
- Yes — The Golden Room LLC's NPI (1205172913) is active in the NPPES registry as of the last update on 2012-12-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.