DAVID LAWRENCE FEDEROFF (NPI# 1356812291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356812291 |
Entity Type | Individual |
Full Name | DAVID LAWRENCE FEDEROFF |
Credential | PA |
Practice Address |
35 Mullins Dr Ste 2 Lebanon OR 97355-3985 |
Practice Telephone | 5414517915 |
Practice Fax Number | 5414517973 |
Mailing Telephone | 5414517915 |
Mailing Fax Number | 5414517973 |
Enumeration Date | 2018-12-17 |
Last Update Date | 2020-01-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA195905 | OR | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
56220 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
9041 Magnolia Ave Ste 107, Riverside, CA 925033942 | 9513531021 |
Street Address |
35 MULLINS DR STE 2 |
City | LEBANON |
State | OR |
Zip Code | 97355-3985 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952340838 | Winnifred Barron | Physician Assistant | 35 Mullins Dr Ste 2, Lebanon, OR 97355-3985 | 2006-06-06 |
1720329873 | Valerie Smith | Physician Assistant | 35 Mullins Dr Ste 2, Lebanon, OR 97355-3985 | 2013-03-13 |
1306881883 | Leslie A Pliskin | Emergency Medicine | 35 Mullins Dr Ste 2, Lebanon, OR 97355-3985 | 2006-06-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
Find all providers in zip 97355 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
1841843174 | Jesse Paul Laughner | Physician Assistant | 735 Norman Dr Ste 8, Lebanon, PA 17042-7559 | 2019-07-16 |
1881868750 | Oronzo Ronald Schiraldi | Physician Assistant | 7 Deer Run, Lebanon, NJ 08833-3004 | 2008-04-22 |
1740211788 | Tammie Wampler | Physician Assistant | 107 Glidepath Way, Lebanon, TN 37090-4133 | 2006-07-06 |
1487610069 | Erin Mcculloch Crisp | Physician Assistant | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-04-24 |
1023013620 | Richard B Halbur | Physician Assistant | 191 N Main St, Lebanon, OR 97355-2870 | 2005-06-20 |
1326679366 | Joshua Christopher Schirripa | Physician Assistant | 675 N 5th St Ste 200, Lebanon, OR 97355-2875 | 2020-01-29 |
1245878420 | Lauren Michelle Eastman | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2019-12-18 |
1164079091 | Sarah A Muse | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2019-08-26 |
1790262525 | Erin Elizabeth Schroeder | Physician Assistant | 2705 N Lebanon St Ste 210, Lebanon, IN 46052-8622 | 2018-07-24 |
Find all providers in LEBANON |
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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.