JUSTIN PAVLOVICH (NPI# 1528238805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528238805 |
| Entity Type | Individual |
| Full Name | JUSTIN PAVLOVICH |
| Credential | M.D. |
| Practice Address |
9250 Sw Hall Blvd Tigard OR 97223-6857 |
| Mailing Address |
9250 Sw Hall Blvd Tigard OR 97223-6721 |
| Practice Telephone | 5032930161 |
| Practice Fax Number | 5034523213 |
| Mailing Telephone | 5032930161 |
| Mailing Fax Number | 5034523200 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2012-07-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 29320 | OR | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 57.006965 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
9250 SW HALL BLVD |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-6857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023005410 | Michael Shihjay Chen | Family Medicine | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2005-09-30 |
| 1861904658 | Donna Marie-rogers Lane | Nurse Practitioner | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2017-11-01 |
| 1811411291 | Tina Louise Landeros | Nurse Practitioner | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2017-07-27 |
| 1558613414 | Katherine Claire Hammond | Nurse Practitioner | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2012-10-02 |
| 1811273402 | Dana L Marasco | Physical Therapist | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2011-10-26 |
| 1326353988 | Barbara Jean Harris | Audiologist | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2010-08-06 |
| 1255644589 | Leigh Hoagland Reece | Physical Therapist | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2010-07-15 |
| 1841501269 | Melinda Lee Meeker | Nurse Practitioner | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2010-06-30 |
| 1336468404 | Burkley Snow | Surgery | 9250 Sw Hall Blvd, Tigard, OR 97223-6721 | 2010-05-27 |
| 1699905836 | Junko Lee | Nurse Practitioner | 9250 Sw Hall Blvd, Tigard, OR 97223 | 2009-07-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396845756 | Steven Gabel | Otolaryngology | 12115 Sw 70th Ave Ste 200, Tigard, OR 97223 | 2006-09-25 |
| 1619069887 | Ertan Raif Esmer | Otolaryngology | 9250 Sw Hall Blvd, Tigard, OR 97223 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1104289933 | Ci An Gerald Tay | Otolaryngology | 3181 Sw Sam Jackson Park Rd, Pv01, Portland, OR 97239 | 2016-03-30 |
| 1922471291 | Caitlin Bertelsen | Otolaryngology | 3303 Sw Bond Ave Ste 15, Portland, OR 97239-4501 | 2015-11-08 |
| 1326467812 | Tyler Scott Weaver | Otolaryngology | 1508 Division St Ste 115, Oregon City, OR 97045-1584 | 2014-04-10 |
| 1013286822 | Lawrence Thomas Eschelman | Otolaryngology | 3585 Cherokee Dr S, Salem, OR 97302-9712 | 2011-12-22 |
| 1962708578 | John A Lindgren, Md PC | Otolaryngology | 9155 Sw Barnes Rd Ste 401, Portland, OR 97225-6631 | 2011-01-28 |
| 1558674861 | Lucas Rein Rudmik | Otolaryngology | 3720 Sw Bond Ave Unit 2210, Portland, OR 97239-4577 | 2010-07-16 |
| 1134447741 | Aleen J Lee | Otolaryngology | 9280 Se Sunnybrook Blvd Ste 300, Clackamas, OR 97015 | 2010-05-06 |
| 1811164262 | Carrie Maiorana Brown | Otolaryngology | 24076 Se Stark St Ste 230, Gresham, OR 97030 | 2008-05-14 |
| 1114193448 | Ryan Jeffrey Li | Otolaryngology | 3181 Sw Sam Jackson Park Rd # 01, Portland, OR 97239-3011 | 2008-05-06 |
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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.