DASTU I AHMAT (NPI# 1346707296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346707296 |
| Entity Type | Individual |
| Full Name | DASTU I AHMAT |
| Practice Address |
55 Nw 23rd St Gresham OR 97030-2640 |
| Practice Telephone | 5039846216 |
| Mailing Telephone | 5039846216 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
11146 | OR | Nursing & Custodial Care Facilities |
| Street Address |
55 NW 23RD ST |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801403910 | Baseti Gelgelu | Custodial Care Facility | 2055 Sw 79th Ave, Portland, OR 97225-3805 | 2020-09-23 |
| 1801402946 | Demeti Gelgelu | Custodial Care Facility | 2010 Sw 79th Ave, Portland, OR 97225-3806 | 2020-09-22 |
| 1447808100 | Remelita Loftin | Custodial Care Facility | 2297 Minnesota St, Eugene, OR 97402-6244 | 2019-08-27 |
| 1316506397 | Stephenie Jo Murdock | Custodial Care Facility | 2355 Baker St, Baker City, OR 97814-2541 | 2019-06-12 |
| 1558837781 | Larisa Kravchuk | Custodial Care Facility | 805 Fir Cone Dr Ne, Keizer, OR 97303-4328 | 2018-10-15 |
| 1386122687 | Diana Elizabeth Gwinn | Custodial Care Facility | 16405 Ne Fargo Cir, Portland, OR 97230-5513 | 2018-07-30 |
| 1376071464 | Mckenzie Living, Incorporated | Custodial Care Facility | 2621 Lone Oak Way, Eugene, OR 97404 | 2017-06-01 |
| 1598292997 | Gateway Assisted Living, Inc. | Custodial Care Facility | 611 N Cloverleaf Loop, Springfield, OR 97477-1188 | 2017-05-16 |
| 1841727617 | Gateway Gardens Assisted Living, Inc. | Custodial Care Facility | 178 Commons Dr, Eugene, OR 97401-8923 | 2017-05-11 |
| 1609314509 | Catherine Jensens Foster Home | Custodial Care Facility | 108 Ash Drive, Rogue River, OR 97537 | 2017-02-10 |
| Find all providers with the same taxonomy | ||||
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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.