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

Shriners Hospitals for Children

Organization Pediatric Orthopaedic Surgery Physician · NPI 1134561020

Shriners Hospitals for Children is a Pediatric Orthopaedic Surgery Physician in Portland, Oregon. Works from 2 locations. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009
Phone: (503) 294-3230
Fax: (503) 221-3701
Show map & directions

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

Additional practice locations (1)

  • 750 Murphy Rd, Medford, OR 97504-8426 — (503) 396-9148

Specialties & licences

Pediatric Orthopaedic Surgery Physician (primary) Taxonomy 207XP3100X

Record details

NPI number1134561020
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Gantt — President · (813) 281-0300
Other names Shriners Hospitals For Children (Professional Services); Shriners Hospitals For Children (Professional Services)
NPI enumeratedJuly 22, 2013
Last updated in NPPESApril 19, 2022
Certification dateApril 19, 2022
Mailing addressPo Box 8500, Lockbox #7642, Philadelphia, PA 19178-7642

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