REDA TAWFIK BASSALY (NPI# 1043551930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043551930 |
| Entity Type | Individual |
| Full Name | REDA TAWFIK BASSALY |
| Credential | PA-C |
| Practice Address |
9427 Sw Barnes Rd Ste 296 Portland OR 97225-6667 |
| Mailing Address |
847 Ne 19th Ave Ste 300 Portland OR 97232-2686 |
| Practice Telephone | 5032973778 |
| Practice Fax Number | 5032977853 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA163414 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA163414 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2035614 | 05 | |
| OR | 500657182 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16770 Sw Edy Rd Ste 216, Sherwood, OR 971409679 | 5032973778 | 5032977853 |
| 19250 Sw 65th Ave Ste 135, Tualatin, OR 970627745 | 5036928560 | 5037830660 |
| 879 Providence Dr, Newberg, OR 971327563 | 5032973778 | 5032977853 |
| 9427 Sw Barnes Rd Ste 296, Portland, OR 972256667 | 5032973778 | 5032977853 |
| Street Address |
9427 SW BARNES RD STE 296 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124020987 | Asha Narasimhan Chesnutt | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2005-08-11 |
| 1215586102 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2019-09-04 |
| 1104238468 | Candace Nicole Meinen | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225 | 2014-05-21 |
| 1376954156 | Crystal Ann Duran | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2014-05-14 |
| 1427476159 | Robert Gerard Wheeler | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2014-03-31 |
| 1881030443 | Michael Hal Bourne Jr. | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2013-05-22 |
| 1154616035 | Stephen Teng-yip Yau | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2011-06-18 |
| 1497910210 | Lianne Liang-jung Lin | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2008-07-21 |
| 1720264476 | Hataya Kristy Poonyagariyagorn | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2008-01-11 |
| 1295929198 | Janis Leigh Denning | Physician Assistant | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2007-09-04 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073081428 | Ishah Marie Price | Physician Assistant | 30 Preble St Apt 663, Portland, ME 04101-4939 | 2018-11-04 |
| 1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
| 1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1871982975 | Colin Storz | Physician Assistant | 3623 N Borthwick Ave, Portland, OR 97227-1218 | 2015-01-13 |
| 1275888729 | Stephanie Calvin | Physician Assistant | 782 College St, Portland, TN 37148-2120 | 2012-07-20 |
| 1174800031 | Carolyn Frances Farrell | Physician Assistant | 450 N Graham St, Portland, OR 97227-1682 | 2011-11-07 |
| 1316130198 | Ronald W Kessler | Physician Assistant | 632 Brighton Ave, Portland, ME 04102-1017 | 2007-08-24 |
| 1124210778 | Honey E.l. Marques | Physician Assistant | 16279 Se Division St, Portland, OR 97236-1971 | 2007-08-16 |
| 1124177902 | Dmitriy Shore | Physician Assistant | 10305 Sw Park Way Ste 300, Portland, OR 97225-5033 | 2007-01-09 |
| 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.