PROVIDENCE ST VINCENT MEDICAL CENTER (NPI# 1033345012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033345012 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Other Organization Name | PROVIDENCE INTEGRATIVE MEDICINE WEST |
| Practice Address |
9135 Sw Barnes Rd Suite 161 Portland OR 97225-6601 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032160246 |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2009-06-04 |
| Authorized Official Name | DENNIS NOONAN (CHIEF FINANCE OFFICER) |
| Authorized Official Telephone | 5032164657 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PROVIDENCE INTEGRATIVE MEDICINE WEST | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578684478 | Providence St Vincent Medical Center | Clinic/Center | 9155 Sw Barnes Rd, Suite 304, Portland, OR 97225-6625 | 2007-04-02 |
| 1770604670 | Providence St Vincent Medical Center | Clinic/Center | 9205 Sw Barnes Rd, 5th Floor South, Portland, OR 97225-6603 | 2007-04-02 |
| Street Address |
9135 SW BARNES RD SUITE 161 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021753 | Stacy K Lewis | Internal Medicine | 9135 Sw Barnes Rd, Ste 261, Portland, OR 97225-6601 | 2005-05-27 |
| 1770068017 | Jason Joy | Occupational Therapist | 9135 Sw Barnes Rd, Portland, OR 97225-6646 | 2018-10-02 |
| 1578041661 | Jaime Musgrave | Physical Therapist | 9135 Sw Barnes Rd, Ste 361, Portland, OR 97225-9720 | 2018-08-01 |
| 1295245629 | Kate Alison O'connor Culligan | Occupational Therapist | 9135 Sw Barnes Rd, Portland, OR 97225-6646 | 2017-10-12 |
| 1952765885 | Brian Frost | Speech-Language Pathologist | 9135 Sw Barnes Rd, Suite 362, Portland, OR 97225-6646 | 2016-04-06 |
| 1649636648 | Laurel Beth Tor | Nurse Practitioner | 9135 Sw Barnes Rd, Portland, OR 97225-6646 | 2016-01-06 |
| 1659736940 | Audrey Whitten | Physical Therapist | 9135 Sw Barnes Rd, Suite 361, Portland, OR 97225-6646 | 2015-12-31 |
| 1265824627 | Kaplan & Sautter LLC | Otolaryngology | 9135 Sw Barnes Rd, Suite 963, Portland, OR 97225-6646 | 2015-02-23 |
| 1811394380 | James Connelly | Pharmacist | 9135 Sw Barnes Rd, Suite 263, Portland, OR 97225-6646 | 2014-11-29 |
| 1992107544 | Kelli R Harrington-bollenbaugh | Speech-Language Pathologist | 9135 Sw Barnes Rd, Ste 261, Portland, OR 97225-6646 | 2014-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1679030290 | Yoana Kanev | Clinic/Center | 3701 Sw Condor Ave Apt C1, Portland, OR 97239-4158 | 2019-03-01 |
| 1841760584 | Orthopedic Needle LLC | Clinic/Center | 328 Ne Failing St Ste C, Portland, OR 97212-1157 | 2018-11-26 |
| 1073081881 | Sober Living Oregon Recovery Center | Clinic/Center | 1122 Ne 122nd Ave Ste A102, Portland, OR 97230-2082 | 2018-11-09 |
| 1366933830 | Dr Frances V Verzosa Md PC | Clinic/Center | 12770 Se Stark St Bldg C, Portland, OR 97233-1539 | 2018-05-21 |
| 1023520814 | Concordia Wellness, LLC | Clinic/Center | 3014 Ne Killingsworth St, Portland, OR 97211-6814 | 2017-11-01 |
| 1114443124 | Zephyr Acupuncture and Bodywork, LLC | Clinic/Center | 4313 Ne Tillamook St, Portland, OR 97213-1315 | 2017-08-22 |
| 1164952495 | Earth Source Medicine | Clinic/Center | 2207 Ne Broadway St Ste 200, Portland, OR 97232-1791 | 2017-06-19 |
| 1902353873 | Siesta Acupuncture LLC | Clinic/Center | 2818 Se 70th Ave, Portland, OR 97206-1117 | 2016-09-08 |
| 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.