DOUGLAS NEWELL RUNCKEL (NPI# 1508974932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508974932 |
| Entity Type | Individual |
| Full Name | DOUGLAS NEWELL RUNCKEL |
| Credential | M.D. |
| Practice Address |
13705 Ne Airport Way Ste C Portland OR 97230-1048 |
| Mailing Address |
3419 Pringle Rd Se Salem OR 97302-2649 |
| Practice Telephone | 5032586846 |
| Practice Fax Number | 5032586864 |
| Mailing Telephone | 5033708988 |
| Mailing Fax Number | 5032586864 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
OR MD09235 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
13705 NE AIRPORT WAY STE C |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-1048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649283193 | Lawrence A Dworkin | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2006-08-15 |
| 1538485487 | Eugene Carneal | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2010-04-18 |
| 1962668566 | Denise I Quigley | Specialist/Technologist, Other | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2008-08-03 |
| 1407021512 | Tom C Deroche | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2008-04-29 |
| 1609927383 | David Scott | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2007-01-16 |
| 1831207372 | Anne Katharine Avery | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2006-08-25 |
| 1609981075 | Karen Anne Oyama | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2006-08-19 |
| 1225141054 | Zheru Liu | Pathology | 13705 Ne Airport Way Ste C, Portland, OR 97230-1048 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1477896975 | Wei Xie | Pathology | 3181 Sw Sam Jackson Rd., Portland, OR 97239-3011 | 2013-04-03 |
| 1114276060 | Joanna Wiszniewska | Pathology | 3181 Sw Sam Jackson Park Rd # L103, Portland, OR 97239-3011 | 2012-09-06 |
| 1629368816 | Aaron Halfpenny | Pathology | 3181 Sw Sam Jackson Park Rd # L-471, Portland, OR 97239-3011 | 2011-04-09 |
| 1568618239 | Cascade Pathology Services, Corp | Pathology | 10340 Sw Nimbus Ave, Suite N-b, Portland, OR 97223-4307 | 2008-08-13 |
| 1508044595 | Reva S. Ricketts-loriaux | Pathology | 3158 Sw Fairmount Blvd, Portland, OR 97239-1467 | 2008-02-01 |
| 1518038363 | Andrew Michael Schreiner | Pathology | 3181 Sw Sam Jackson Park Rd # L113, Portland, OR 97239-3011 | 2006-11-13 |
| 1184735524 | Donna E Hansel | Pathology | 3181 Sw Sam Jackson Park Rd # L-113, Portland, OR 97239-3011 | 2006-08-31 |
| 1689781056 | Chad D Galderisi | Pathology | 1341 Sw Custer Dr, Portland, OR 97219 | 2006-08-23 |
| 1336152735 | Edwin K Chinn | Pathology | 13705 Ne Airport Way, Suite C, Portland, OR 97230-1048 | 2006-08-15 |
| 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.