DR. SHEVYLL ARVIE SIONG TAN (NPI# 1376720052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376720052 |
| Entity Type | Individual |
| Full Name | DR. SHEVYLL ARVIE SIONG TAN |
| Credential | M.D. |
| Practice Address |
24988 Stark. St., Legacy Medical Group Mount Hood Suite 220 Medical Office Bldg 3 Gresham OR 97030 |
| Mailing Address |
Po Box 4365 Portland OR 97208-4365 |
| Practice Telephone | 9525834791 |
| Mailing Telephone | 5034133900 |
| Mailing Fax Number | 5034133710 |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2018-09-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD186467 | OR | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 50459 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17 Exchange St W Ste 500, Saint Paul, MN 55102 | 9525834791 |
| Street Address |
24988 STARK. ST., LEGACY MEDICAL GROUP MOUNT HOOD SUITE 220 MEDICAL OFFICE BLDG 3 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619173085 | Regina S. Won | Internal Medicine | 24800 Se Stark St Fl 3, Legacy Medicine Inpatient Service, Gresham, OR 97030 | 2007-06-22 |
| 1134204340 | Gresham Internal Medicine Clinic | Internal Medicine | 24900 Se Stark St Ste 109, Gresham, OR 97030-3381 | 2006-10-26 |
| 1952497307 | Maureen Ann Wright | Internal Medicine | 831 Nw Council Dr Ste 125, Gresham, OR 97030-3794 | 2006-10-05 |
| 1730133679 | Sunita M Deshmukh | Internal Medicine | 440 Nw Division St, Gresham, OR 97030-5506 | 2006-05-22 |
| 1033183918 | Amy Katherine Chaumeton | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2006-02-15 |
| 1770561813 | John M Custis | Internal Medicine | 24900 Se Stark, Ste 109, Gresham, OR 97030 | 2006-01-09 |
| 1972078590 | Portland Adventist Medical Center | Internal Medicine | 831 Nw Council Dr Ste 125, Gresham, OR 97030-3794 | 2018-10-10 |
| 1760878243 | Matthew Sabongi | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2015-04-10 |
| 1073951208 | Brittney B Mensen | Internal Medicine | 831 Nw Council Dr Ste 101, Gresham, OR 97030-3722 | 2013-06-10 |
| 1568805786 | Nicholas Beach | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2013-04-08 |
| Find all providers in GRESHAM | ||||
Please comment or provide details below to improve the information on DR. SHEVYLL ARVIE SIONG TAN.
| 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.