OREGON CLINIC PC (NPI# 1497046205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497046205 |
| Entity Type | Organization |
| Organization Name | OREGON CLINIC PC |
| Practice Address |
1111 Ne 99th Ave Ste 200 Portland OR 97220 |
| Mailing Address |
Po Box 5277 Portland OR 97208-5277 |
| Practice Telephone | 5039633030 |
| Practice Fax Number | 5039633140 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2018-12-18 |
| Authorized Official Name | CRAIG STEPHEN FAUSEL (CEO PRESIDENT) |
| Authorized Official Telephone | 5039632801 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 160412 | OR | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265417174 | Oregon Clinic PC | Obstetrics & Gynecology | 847 Ne 19th Ave, Suite 300, Portland, OR 97232-2684 | 2005-12-13 |
| 1215586102 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2019-09-04 |
| 1366699464 | Oregon Clinic PC | Specialist | 315 Se Stonemill Dr, Suite 220, Vancouver, WA 98684-6998 | 2008-08-20 |
| 1417112616 | Oregon Clinic PC | Specialist | 875 Oak St Se, Suite 5020, Salem, OR 97301-3975 | 2008-07-28 |
| 1003944042 | Oregon Clinic PC | Durable Medical Equipment & Medical Supplies | 1111 Ne 99th Avenue, Portland, OR 97220 | 2007-03-01 |
| Street Address |
1111 NE 99TH AVE STE 200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184824351 | Rick Balestra | Internal Medicine | 1111 Ne 99th Ave Ste 200, Portland, OR 97220-9442 | 2007-07-24 |
| 1417594664 | Brianna Elizabeth-o'mara Costello | Physician Assistant | 1111 Ne 99th Ave Ste 200, Portland, OR 97220-9442 | 2019-12-06 |
| 1457866865 | Sara Villegas-keech | Physician Assistant | 1111 Ne 99th Ave Ste 200, Portland, OR 97220-9442 | 2017-12-07 |
| 1881986404 | Andrew Kelly Levy | Internal Medicine | 1111 Ne 99th Ave Ste 200, Portland, OR 97220 | 2011-05-16 |
| 1912298696 | Granthem T Farr | Internal Medicine | 1111 Ne 99th Ave Ste 200, Portland, OR 97220 | 2011-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794181 | Wound Pros Oregon | Durable Medical Equipment & Medical Supplies | 10260 Sw Greenburg Road 4th Floor, Portland, OR 97223-5500 | 2020-09-12 |
| 1881209385 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12555 Nw Cornell Rd, Portland, OR 97229-5683 | 2020-09-11 |
| 1184260325 | Pacific O&p LLC | Durable Medical Equipment & Medical Supplies | 1050 Sw 6th Ave Ste 1100, Portland, OR 97204-1153 | 2019-11-22 |
| 1508417247 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 165 Lancaster St Ste P, Portland, ME 04101-2406 | 2019-09-24 |
| 1386294379 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8145 Se 17th Ave, Portland, OR 97202-6718 | 2019-09-12 |
| 1346899721 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 345 Sw Harrison St, Portland, OR 97201-5364 | 2019-09-09 |
| 1841753050 | Regional Home Care Inc. | Durable Medical Equipment & Medical Supplies | 190 Riverside St Unit 2b, Portland, ME 04103-1073 | 2019-04-14 |
| 1154889137 | Julie Marie Conaway | Durable Medical Equipment & Medical Supplies | 1302 Wildcat Dr, Portland, TX 78374-2812 | 2019-03-08 |
| 1225503188 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3036 Ne Martin Luther King Jr Blvd Ste 136, Portland, OR 97212-3053 | 2018-10-08 |
| 1588140321 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3031 Se Powell Blvd, Portland, OR 97202-1955 | 2018-07-16 |
| 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.