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

Fanno Creek Clinic LLC

Organization Internal Medicine Physician · NPI 1609876705

Fanno Creek Clinic LLC is an Internal Medicine Physician in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2005.

Licensed in
OR
In the registry since
2005
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

2400 SW Vermont St
Portland, OR 97219-1940
Phone: (503) 452-0915
Fax: (503) 768-9232
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2802 (OR)

Record details

NPI number1609876705
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry Reed — Clinic Manager · (503) 452-0915
NPI enumeratedJuly 29, 2005
Last updated in NPPESOctober 16, 2007
Mailing address2400 Sw Vermont St, Portland, OR 97219-1940

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