DR. MICHELE RADDISH (NPI# 1114116969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114116969 |
| Entity Type | Individual |
| Full Name | DR. MICHELE RADDISH |
| Credential | MD |
| Practice Address |
830 Ne 47th Ave Providence Neurodevelopmental Center for Children Portland OR 97213 |
| Mailing Address |
560 Milburn Ct Lake Oswego OR 97034-1654 |
| Practice Telephone | 5032162339 |
| Mailing Telephone | 5036970958 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2020-10-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
MD2013-0227 | NM | Allopathic & Osteopathic Physicians |
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
MD23415 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
830 NE 47TH AVE PROVIDENCE NEURODEVELOPMENTAL CENTER FOR CHILDREN |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1225521404 | Lydia Eve Jahn | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-06-12 |
| 1669970521 | Gabriela Barajas Quiroz | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-25 |
| 1053829663 | Carol Lipson Criswell | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-17 |
| 1649788241 | Diane Cervi | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-17 |
| 1740793579 | Katie Lynn Harris | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-11-15 |
| 1629597935 | Paige Wollenzien | Dietitian, Registered | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-09-18 |
| 1831631753 | Darrick Stiff | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-11-09 |
| 1871042044 | Rebecca Spencer | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-28 |
| 1508313842 | Amy Grimm | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477616845 | Charlene Sabin | Pediatrics | 5441 Sw Macadam Ave Ste 200, Portland, OR 97239-3822 | 2006-12-18 |
| 1285604173 | Donna K Kirchoff | Pediatrics | 1675 Sw Marlow Ave, Ste 200, Portland, OR 97225-5104 | 2006-01-24 |
| 1023454089 | Samantha Dunn | Pediatrics | 1577 Congress St, Portland, ME 04102-2169 | 2013-05-17 |
| 1457579914 | Gisela Porras Serna | Pediatrics | 2801 N Gantenbein Ave Ste 2225, Portland, OR 97227-1623 | 2007-04-23 |
| 1568680239 | Martine Richardson Sacks | Pediatrics | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2007-04-20 |
| 1598834533 | David W Willis | Pediatrics | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225-5104 | 2006-11-06 |
| 1184704363 | Kendra Higgins Farris | Pediatrics | 2801 N Gantenbein Ave, Pediatric Development & Rehabilitation Program, Portland, OR 97227-1623 | 2006-10-16 |
| 1124115936 | Mary Lynn O'brien | Pediatrics | 3600 N Interstate Ave, Portland, OR 97227-1106 | 2006-10-05 |
| 1164517454 | James N Powell | Pediatrics | 3600 N Interstate Ave, Portland, OR 97227-1106 | 2006-10-04 |
| 1508963380 | Robin Nemer Mccoy | Pediatrics | 707 Sw Gaines St, Portland, OR 97239-2901 | 2006-09-20 |
| 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.