DR. PAUL E VANBREDAVRIESMAN (NPI# 1043453582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043453582 |
| Entity Type | Individual |
| Full Name | DR. PAUL E VANBREDAVRIESMAN |
| Credential | M.D. |
| Practice Address |
18000 Se Stark Street Gresham OR 97233 |
| Mailing Address |
16244 Ne San Rafael Dr 18000 Se Stark Street Portland OR 97230-5661 |
| Practice Telephone | 5032554243 |
| Practice Fax Number | 5032554243 |
| Mailing Telephone | 5032554243 |
| Mailing Fax Number | 5032554243 |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
MD11073 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
18000 SE STARK STREET |
| City | GRESHAM |
| State | OR |
| Zip Code | 97233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700421435 | Carehere LLC | Family Medicine | 12106 Ne Ainsworth Cir Ste 5, Portland, OR 97220-9001 | 2019-11-18 |
| 1053839217 | Transitional Life Care Clinic, Inc. | Family Medicine | 15604 Sw Rock of Ages Rd, Mcminnville, OR 97128-8531 | 2017-09-07 |
| 1588088785 | Robert Michael Hakala | Family Medicine | 2300 Neff Road, Volunteers In Medicine Clinic, Bend, OR 97701 | 2014-02-07 |
| 1538495734 | Ole Hansen | Family Medicine | 2605 State St, Salem, OR 97310-1346 | 2009-10-22 |
| 1154548881 | Leta Teresa Callahan | Family Medicine | 230 Rowe Road, Wheeler, OR 97147 | 2007-04-20 |
| 1952527871 | Ben Harold Douglas II | Family Medicine | 1100 3rd St, Tillamook, OR 97141-3402 | 2007-04-18 |
| 1629109335 | Melissa Noble | Family Medicine | 628 N Main Street, Ashland, OR 97520-1710 | 2007-03-07 |
| 1730275488 | Richard Hansen | Family Medicine | 300 N Mill St Ste A, Creswell, OR 97426-9848 | 2006-10-04 |
| 1376584011 | Leonard Dewitt Savage | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2006-06-10 |
| 1346202082 | David Snook | Family Medicine | 367 Normal Ave, Ashland, OR 97520-1329 | 2006-04-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. PAUL E VANBREDAVRIESMAN.
| 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.