SPORTS HEALTH NORTHWEST INC (NPI# 1346863727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346863727 |
| Entity Type | Organization |
| Organization Name | SPORTS HEALTH NORTHWEST INC |
| Practice Address |
12672 Nw Barnes Rd Ste 100 Portland OR 97229-6191 |
| Practice Telephone | 5037476376 |
| Practice Fax Number | 5035308406 |
| Mailing Telephone | 5037476376 |
| Mailing Fax Number | 5035308406 |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-10-24 |
| Authorized Official Name | DR. DAVID N WESTERDAHL (OWNER) |
| Authorized Official Telephone | 5037476376 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
12672 NW BARNES RD STE 100 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-6191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356305023 | David N Westerdahl | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2006-04-12 |
| 1124507827 | Portland Foot and Ankle Institute, LLC | Podiatrist | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2018-08-13 |
| 1255547782 | Maureen Shenker | Physician Assistant | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801079074 | Jennifer Dawn Kleinman | Family Medicine | 5704 N Montana Ave, Portland, OR 97217-4643 | 2007-12-11 |
| 1871558353 | Douglas Bruce Mckeag | Family Medicine | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2006-04-19 |
| 1356305023 | David N Westerdahl | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2006-04-12 |
| 1396739520 | William W Dexter | Family Medicine | 272 Congress St, Portland, ME 04102 | 2005-09-02 |
| 1518347897 | James Suchy | Family Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3079 | 2015-06-02 |
| 1508278904 | James Alex | Family Medicine | 22 Bramhall St, Portland, ME 04102-3134 | 2014-05-20 |
| 1407266778 | Mary Iaculli | Family Medicine | 331 Veranda St, Portland, ME 04103-5545 | 2014-05-07 |
| 1114213667 | Alison Savage Lee | Family Medicine | 33 Sewall St, Portland, ME 04102-2603 | 2011-06-23 |
| 1952575391 | Melissa A. Novak | Family Medicine | 4411 Sw Vermont St, Gabriel Park Family Health Center, Portland, OR 97219-1020 | 2008-04-16 |
| 1174793301 | Ryan Carl Petering | Family Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-03-04 |
| 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.