MICHELE SHIVACK


Address: 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914
Phone: 5039064323

MICHELE SHIVACK (NPI# 1184962128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184962128
Entity Type Individual
Full Name MICHELE SHIVACK
Credential PT,ATC
Practice Address 11782 Sw Barnes Rd
Suite 300
Portland
OR 97225-5914
Practice Telephone 5039064323
Practice Fax Number 5039064333
Mailing Telephone 5039064323
Mailing Fax Number 5039064333
Enumeration Date 2013-01-25
Last Update Date 2013-09-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2251S0007X Physical Therapist
Specialization: Sports
4108 OR Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 2251X0800X Physical Therapist
Specialization: Orthopedic
04108 OR Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR LICENSE NUMBER 04108 01

Office Location

Street Address 11782 SW BARNES RD
SUITE 300
City PORTLAND
State OR
Zip Code 97225-5914

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801889399 Brett M Andres Orthopaedic Surgery 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 2005-08-30
1982179560 Andrew Stanton Physician Assistant 11782 Sw Barnes Rd, Portland, OR 97225-5914 2018-10-10
1790226322 Melissa Ann Senn-reis Specialist/Technologist 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 2017-03-15
1902344187 Corvin W Tompkins Specialist/Technologist, Other 11782 Sw Barnes Rd, Suite 200, Portland, OR 97225-5914 2017-02-07
1073059754 Daniel Lewis Fisher Specialist/Technologist, Other 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 2017-01-18
1891189056 Martha Miller Specialist/Technologist 11782 Sw Barnes Rd, Portland, OR 97225-5914 2015-03-26
1598170425 Ashley Wood Physician Assistant 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 2014-06-30
1366799405 Jessica Lynn Martschinske Specialist/Technologist 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225-5914 2012-08-08
1235485053 Nick Adam George Physical Therapist 11782 Sw Barnes Rd, Ste 100, Portland, OR 97225-5914 2012-07-30
1821370875 Limelight Group Anesthesiology 11782 Sw Barnes Rd, Building C Suite 200, Portland, OR 97225-5914 2011-09-15
Find all providers in the same location

Providers in the same zip code

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 Information

Taxonomy Code 2251X0800X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Orthopedic

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578170411 Mind Body Therapy Physical Therapist 11959 Sw Garden Pl, Portland, OR 97223-8249 2020-09-24
1306324538 Kristin Connor Messing Physical Therapist 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 2018-07-31
1093204562 Jessica Hund Physical Therapist 9385 Sw Greenburg Rd Ste 100, Portland, OR 97223-3200 2018-05-09
1659899151 Mariel Hammond Physical Therapist 7522 N Lombard St, Portland, OR 97203-3235 2017-09-05
1437516515 Caleb Joseph Wright Physical Therapist 8628 Se 17th Ave, Portland, OR 97202-0000 2016-01-20
1881840692 Jennifer Lynne Davis Physical Therapist 7718 Se 13th Ave, Portland, OR 97202-6348 2008-08-12
1093977316 Julie A Jacobson Physical Therapist 10428 Ne Pacific St, Portland, OR 97220-4028 2008-06-27
1427225606 Kofoed Enteprises PC Physical Therapist 1020 Sw Taylor Street Suite 665, Portland, OR 97205-2529 2008-05-15
1770619595 Shawn Patrick Cooney Physical Therapist 3108 Ne 181st Ave, Portland, OR 97230-6926 2007-02-26
1811039035 Kevin A Schmidt Physical Therapist 2622 Se 25th Ave, Suite B, Portland, OR 97202-1217 2007-02-13
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97225

Improve Information

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Dataset Information

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.

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