LUCAS ENEN ANNABELL (NPI# 1023547015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023547015 |
Entity Type | Individual |
Full Name | LUCAS ENEN ANNABELL |
Credential | MD |
Practice Address |
3101 Sw Sam Jackson Park Rd Portland OR 97239-3009 |
Mailing Address |
Po Box 8500, Lockbox 7642 Shriners Hospitals for Children, Portland Philadelphia PA 19178-7642 |
Practice Telephone | 5032213424 |
Practice Fax Number | 5032213490 |
Mailing Telephone | (813) 281-8115 |
Mailing Fax Number | 8132818656 |
Enumeration Date | 2017-06-05 |
Last Update Date | 2017-09-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | OR | Student, Health Care | |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
3101 SW SAM JACKSON PARK RD |
City | PORTLAND |
State | OR |
Zip Code | 97239-3009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710968375 | Brookley Valentine Holter | Physician Assistant | 3101 Sw Sam Jackson Park Rd, Shriner's Hospital for Children, Portland, OR 97239 | 2005-11-10 |
1932743127 | Sarah Virginia Lowe | Dietitian, Registered | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2019-10-31 |
1548802960 | Richard Hannan | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2019-10-17 |
1558902262 | Janan Chandrananth | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2019-10-03 |
1245893007 | Elizabeth Ann Mandel | Nurse Practitioner | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2019-04-17 |
1104396589 | Rebecca-kelly Grant Clark | Occupational Therapist | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2018-11-28 |
1336629294 | Joel Hamilton Cowley | Physical Therapist | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2018-08-20 |
1104314350 | Shriners Hospitals for Children | Anesthesiology | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2018-04-24 |
1356863765 | Stephen Arran Butler | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2017-07-07 |
1255873535 | Seth Michael Tarrant | Student in an Organized Health Care Education/Training Program | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 | 2016-11-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
Find all providers in zip 97239 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
1669081659 | Amy Hill | Student in an Organized Health Care Education/Training Program | 3931 N Juneau St Apt 7, Portland, OR 97217-7419 | 2020-07-27 |
1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
1558986364 | Haley Bosco Doyle | Student in an Organized Health Care Education/Training Program | 3587 Se Grant St, Portland, OR 97214-5829 | 2020-06-08 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.