AMY NICOLE MANDEVILLE (NPI# 1225478126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225478126 |
| Entity Type | Individual |
| Full Name | AMY NICOLE MANDEVILLE |
| Practice Address |
8935 Se Powell Blvd Portland OR 97266-1938 |
| Mailing Address |
710 Riverside Dr Waupaca WI 54981-1941 |
| Practice Telephone | 5037724335 |
| Practice Fax Number | 5037724337 |
| Mailing Telephone | 7152563000 |
| Mailing Fax Number | 7152563039 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2020-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MD178973 | OR | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 73650 | WI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MRM-1324 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
8935 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-1938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679526107 | Yakima Valley Farm Workers Clinic | Clinic/Center | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2006-05-18 |
| 1811549090 | Carol Anne Simpson | Dietitian, Registered | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2019-07-09 |
| 1275027849 | Karen Eliana Straehley | Physician Assistant | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2018-06-18 |
| 1235626441 | Laboratory Corporation of America | Clinical Medical Laboratory | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2018-04-13 |
| 1114453396 | Jemie Walrod | Family Medicine | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2017-05-05 |
| 1477090058 | Katelyn Occhipinti | Registered Nurse | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2017-01-20 |
| 1255885810 | Heather Tahler | Psychologist | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2016-08-11 |
| 1629521737 | Cuong Thai | Community Health Worker | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2016-07-26 |
| 1427404243 | Anthony Bellsmith | Family Medicine | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2016-05-11 |
| 1912316407 | Elizabeth Briggs | Psychologist | 8935 Se Powell Blvd, Portland, OR 97266-1938 | 2014-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
| Find all providers in zip 97266 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639710783 | Christine Elizabeth O'connor | Family Medicine | 6336 Se 61st Ave, Portland, OR 97206-6718 | 2019-09-30 |
| 1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
| 1063064285 | Victoria A Deane | Family Medicine | 37 Fall Brook St, Portland, ME 04103-4224 | 2019-07-09 |
| 1598238214 | Whole Systems Healthcare | Family Medicine | 1020 Sw Taylor St Ste 340, Portland, OR 97205-2508 | 2019-01-04 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1871943159 | Micah Kiehl | Family Medicine | 4427 Ne Fremont St, Portland, OR 97213-1153 | 2016-06-16 |
| 1083068589 | Carrie Lynn Binder | Family Medicine | 1035 Nw Northrup St, Portland, OR 97209-3017 | 2016-04-20 |
| 1437513835 | Kayce A Spear | Family Medicine | 10803 Se Cherry Blossom Drive, Portland, OR 97216-3107 | 2016-04-12 |
| 1992175509 | Lone Star Evaluations Inc. | Family Medicine | 1500 Wildcat Dr Ste M, Portland, TX 78374-2826 | 2015-09-25 |
| 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.