NOVAM-NUTRITION LLC (NPI# 1376952275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376952275 |
| Entity Type | Organization |
| Organization Name | NOVAM-NUTRITION LLC |
| Practice Address |
15455 Nw Greenbrier Pkwy Suite #100 Beaverton OR 97006-7374 |
| Practice Telephone | 8554166826 |
| Practice Fax Number | 3603261621 |
| Mailing Telephone | 8554166826 |
| Mailing Fax Number | 3603261621 |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |
| Authorized Official Name | MR. DAVID LINDSLEY (PRESIDENT) |
| Authorized Official Telephone | 8554166826 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 335G00000X | Medical Foods Supplier | Suppliers |
| Street Address |
15455 NW GREENBRIER PKWY SUITE #100 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-7374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235131624 | Dean A Moshofsky | Pediatrics | 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006-7374 | 2005-08-15 |
| 1245771369 | Body & Face LLC | Massage Therapist | 15455 Nw Greenbrier Pkwy, Suite 120, Beaverton, OR 97006-7374 | 2017-03-09 |
| 1992243034 | Source Health Center | Chiropractor | 15455 Nw Greenbrier Pkwy, Suite #150, Beaverton, OR 97006-7374 | 2017-02-09 |
| 1164799813 | Rebecca Berzow | Naturopath | 15455 Nw Greenbrier Pkwy, Suite 100, Beaverton, OR 97006-7374 | 2011-11-23 |
| 1508142894 | Sharon Suzanne Carter | Social Worker | 15455 Nw Greenbrier Pkwy, Suite 240, Beaverton, OR 97006-7374 | 2011-10-31 |
| 1053610527 | Sherry L Sweeney | Nurse Practitioner | 15455 Nw Greenbrier Pkwy, Suite 111, Beaverton, OR 97006-7374 | 2011-03-22 |
| 1740588185 | Columbia Care LLC | In Home Supportive Care | 15455 Nw Greenbrier Pkwy, Ste 205, Beaverton, OR 97006-7374 | 2011-03-09 |
| 1417151382 | Sara Murdick | Pediatrics | 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006-7374 | 2007-06-13 |
| 1174646129 | Perio Aesthetics & Implantology | Dentist | 15455 Nw Greenbrier Pkwy, Suite 235, Beaverton, OR 97006-7374 | 2007-04-06 |
| 1881714061 | 2 Roads Crossing Healthcare, PC | Psychologist | 15455 Nw Greenbrier Pkwy, Suite 240, Beaverton, OR 97006-8116 | 2007-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 335G00000X |
| Grouping | Suppliers |
| Classification | Medical Foods Supplier |
| A supplier of special replacement foods for clients with errors of metabolism that prohibit them from eating a regular diet. Medical foods are lacking in the compounds which cause complications of the metabolic disorder, and are not generally available in grocery stores, health food stores, or pharmacies. |
| Notes: Source: The Children with Special Healthcare Needs (CSHCN) Services Program, a program of the Texas Department of State Health Services |
Please comment or provide details below to improve the information on NOVAM-NUTRITION LLC.
| 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.