Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Burnside Surgery Center LLC

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1013417351

Burnside Surgery Center LLC is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Gresham, Oregon. Licensed in Oregon. Registered with an NPI since 2018.

Licensed in
OR
In the registry since
2018
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

689 NW Burnside Rd Fl 1
Gresham, OR 97030-3739
Phone: (503) 382-8140
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 07-1645 (OR)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X · Licence MD28526 (OR)

Record details

NPI number1013417351
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Oleg Maksimov — Director · (503) 915-9217
NPI enumeratedFebruary 13, 2018
Last updated in NPPESMay 23, 2021
Certification dateMay 23, 2021
Mailing address689 Nw Burnside Rd Fl 1, Gresham, OR 97030-3739

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