Fanno Creek Clinic LLC
NPI 1609876705 · Internal Medicine Physician · Portland, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Fanno Creek Clinic LLC is a Internal Medicine Physician organization in Portland, OR (NPI 1609876705).
Provider details
- NPI number
- 1609876705
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Larry Reed, Clinic Manager(503) 452-0915
- License
- 2802 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
21 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
Mailing address
Registry dates
- Enumerated
- 2005-07-29
- Last updated
- 2007-10-16
Frequently asked questions
- What is Fanno Creek Clinic LLC's NPI number?
- Fanno Creek Clinic LLC's National Provider Identifier (NPI) is 1609876705, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fanno Creek Clinic LLC?
- Fanno Creek Clinic LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Fanno Creek Clinic LLC located?
- Fanno Creek Clinic LLC's practice location on file with NPPES is 2400 Sw Vermont St, Portland, OR 97219-1940.
- What is Fanno Creek Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Fanno Creek Clinic LLC is (503) 452-0915.
- Does Fanno Creek Clinic LLC accept Medicare?
- Fanno Creek Clinic LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Fanno Creek Clinic LLC?
- The authorized official listed on Fanno Creek Clinic LLC's NPPES record is Larry Reed, Clinic Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fanno Creek Clinic LLC's NPI active?
- Yes — Fanno Creek Clinic LLC's NPI (1609876705) is active in the NPPES registry as of the last update on 2007-10-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.