MOLLY RADIS (NPI# 1306228200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306228200 |
| Entity Type | Individual |
| Full Name | MOLLY RADIS |
| Credential | PNP |
| Practice Address |
2200 Ne Professional Ct Bend OR 97701-6063 |
| Practice Telephone | 5413896313 |
| Practice Fax Number | 5413898760 |
| Mailing Telephone | 5413896313 |
| Mailing Fax Number | 5413898760 |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
201503488NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2200 NE PROFESSIONAL CT |
| City | BEND |
| State | OR |
| Zip Code | 97701-6063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992793988 | Jennifer G. Lachman | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2005-10-12 |
| 1740889781 | Georgia Elizabeth Brown | Dietitian, Registered | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-10-21 |
| 1417554718 | Elizabeth Paige | Social Worker | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-10-08 |
| 1043825490 | Shelanna Rae Burton | Community Health Worker | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2020-09-12 |
| 1942695028 | Dana Elizabeth Honzel Angelos | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2015-04-05 |
| 1871936880 | Kristopher Cox | Physician Assistant | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2013-04-09 |
| 1609158161 | Hailey Marie Garside | Nurse Practitioner | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2011-09-12 |
| 1295050680 | Leslie Austin Rust | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701 | 2010-03-29 |
| 1144552936 | Trisha D Stephens | Dietitian, Registered | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2010-02-04 |
| 1588806343 | Marla Kosydar | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2009-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255662953 | Elizabeth T Millan | Nurse Practitioner | 2150 Ne Daggett Ln, Bend, OR 97701-6560 | 2010-01-19 |
| 1225382617 | Juniper Ridge Developmental and Behavioral Pediatrics | Nurse Practitioner | 62930 O B Riley Rd Ste 300, Bend, OR 97703-9459 | 2012-11-06 |
| 1609158161 | Hailey Marie Garside | Nurse Practitioner | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2011-09-12 |
| 1063584191 | Pamela Jean Lundy | Nurse Practitioner | 2577 Ne Courtney Dr, Bend, OR 97701-7638 | 2006-11-14 |
| 1386620763 | Nancy L Semich | Nurse Practitioner | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197705 | Kelsey-jo Audrey Moss | Nurse Practitioner | 704b Ne 62nd Ave, Portland, OR 97213-4351 | 2019-10-30 |
| 1295273399 | Shaudine Woody | Nurse Practitioner | 11790 Sw Barnes Rd Ste 140, Portland, OR 97225-5938 | 2017-02-08 |
| 1457707390 | Sarah Halstead | Nurse Practitioner | 2421 Washburn Way, Klamath Falls, OR 97603-4525 | 2016-05-10 |
| 1164829578 | Debdeep Nath | Nurse Practitioner | 12225 Sw 2nd St Ste 150, Beaverton, OR 97005 | 2014-12-01 |
| 1003239120 | Iva Juric | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239-3011 | 2014-01-24 |
| 1912339896 | Gabrielle Marie Petersen | Nurse Practitioner | 1713 Penn Ln, Oregon City, OR 97045-1528 | 2013-08-02 |
| 1811249592 | Pollee Hruby Brookings | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw7, Portland, OR 97239-3098 | 2012-10-05 |
| 1033470646 | Chelsea Doherty | Nurse Practitioner | 14480 Sw 90th Ave, Portland, OR 97224 | 2012-05-31 |
| 1972814440 | Alicia Marie Mcintire | Nurse Practitioner | 995 Willagillespie Rd # 100, Eugene, OR 97401-2186 | 2010-06-29 |
| 1083862874 | Catherine M Coffey | Nurse Practitioner | 142 Dearborn St, Union, OR 97883 | 2008-09-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MOLLY RADIS.
| 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.