NPI 1124656608 · live from the CMS NPI Registry
Irvan Bubic, MD
Anesthesiology, Pain Medicine in Portland, OR. National Provider Identifier 1124656608, active.
NPI record
| NPI | 1124656608 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology, Pain Medicine 207LP2900X |
| Practice location | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 |
| Practice phone | 503-494-7551 |
| Mailing address | 1400 Sw 5th Ave Ste 500, Portland, OR 97201 |
| Enumerated | March 30, 2020 |
| Last updated | July 2, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Medicine | 207P00000X | MD219144 (OR) |
| Anesthesiology, Pain Medicine primary | 207LP2900X | MD219144 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.