DR. IDA MOADAB (NPI# 1205147675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205147675 |
| Entity Type | Individual |
| Full Name | DR. IDA MOADAB |
| Credential | PH.D. |
| Practice Address |
101 E Broadway Ste 400 Eugene OR 97401-3104 |
| Mailing Address |
291 W 12th Ave Eugene OR 97401-3409 |
| Practice Telephone | 5413579764 |
| Mailing Telephone | 5413579764 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2019-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2510 | OR | Behavioral Health & Social Service Providers |
| Street Address |
101 E BROADWAY STE 400 |
| City | EUGENE |
| State | OR |
| Zip Code | 97401-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787755 | Shannon Lee Henry | Psychologist | 101 E Broadway Ste 400, Eugene, OR 97401-3104 | 2020-10-12 |
| 1477101160 | Michael Louis Carrizales | Psychologist | 101 E Broadway Ste 400, Eugene, OR 97401-3104 | 2019-08-27 |
| 1376015610 | Eugene Center for Anxiety and Stress, LLC | Psychologist | 101 E Broadway Ste 400, Eugene, OR 97401-3104 | 2018-12-27 |
| 1437517562 | Lisa Oland | Counselor | 101 E Broadway Ste 400, Eugene, OR 97401 | 2016-02-03 |
| 1538581905 | Michael Unger | Counselor | 101 E Broadway Ste 400, Eugene, OR 97401-3104 | 2014-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427681709 | Sarah Voigt | Counselor | 2149 Centennial Plaza Suite #4, Eugene, OR 97401 | 2020-02-14 |
| 1801426242 | Therapeutic Associates, Inc. | Physical Therapist | 760 Charnelton St., Suite 760, Eugene, OR 97401 | 2020-01-24 |
| 1225676232 | Aaron James Barber | Massage Therapist | 1375 Pearl St, Eugene, Or 97401, Eugene, OR 97401 | 2019-12-20 |
| 1851957047 | Altru Home Care LLC | Nursing Care | 1345 Olive St., Eugene, OR 97401 | 2019-05-14 |
| 1881155208 | Herron Jordanna Spence | Speech-Language Pathologist | 385 West 2nd Ave., Eugene, OR 97401 | 2019-03-28 |
| 1750855094 | Brandon Marshall | Counselor | 1158 High St Ste 202, Eugene, OR 97401 | 2019-01-21 |
| 1881172591 | Kayla Nicole O'brien | Nurse Practitioner | Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 | 2018-08-03 |
| 1962992180 | Shannon Jensen Smyth | Counselor | Va Eugene Downtown Clinic, 211 E. 7th Ave, Eugene, OR 97401 | 2018-05-14 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1821507344 | Anjuli Chitkara | Psychologist | 1679 Willamette Street, Eugene, OR 97401 | 2017-09-27 |
| Find all providers in zip 97401 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377188 | Lois Michaud, Ph.d. | Psychologist | 570 Lawrence St Ste 106, Eugene, OR 97401-2586 | 2020-05-15 |
| 1114498854 | Western Clinical & Forensic Services | Psychologist | 1400 Executive Pkwy Ste 260, Eugene, OR 97401-7121 | 2018-12-06 |
| 1992247795 | Gina Sprague-connors | Psychologist | Eugene Va Downtown Clinic 211 E. 7th Avenue, Unit 118, Eugene, OR 97401 | 2016-11-09 |
| 1053703686 | Paul Rohde | Psychologist | 2460 Polk St, Eugene, OR 97405-1837 | 2015-02-18 |
| 1891121802 | Alexander Smith | Psychologist | 44 Club Rd Ste 200, Eugene, OR 97401-2460 | 2013-09-23 |
| 1578803169 | Timothy Daniel Forester | Psychologist | 90869 Coburghills Dr, Eugene, OR 97408-9422 | 2013-02-19 |
| 1609015049 | Jason Quiring | Psychologist | 895 Pine Forest Dr, Box 5585, Eugene, OR 97405-4070 | 2009-02-09 |
| 1144499740 | Matthew J. Fleischman, Phd, PC | Psychologist | 915 Oak St Ste 300, Eugene, OR 97401-3142 | 2008-02-27 |
| 1891977815 | Amy Beth Athey | Psychologist | 3250 Queens East St, Eugene, OR 97401-8516 | 2007-11-30 |
| 1326235151 | Mason Fries | Psychologist | 3780 Vine Maple St, Eugene, OR 97405-4459 | 2007-09-25 |
| Find all providers in EUGENE | ||||
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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.