STEPHEN ANTHONY WALCOTT JR. (NPI# 1528315801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528315801 |
| Entity Type | Individual |
| Full Name | STEPHEN ANTHONY WALCOTT JR. |
| Practice Address |
5230 Se Roethe Rd Milwaukie OR 97267-5051 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5036529092 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
5230 SE ROETHE RD |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97267-5051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447525506 | Cascadia Behavioral Healthcare | Community Based Residential Treatment Facility, Mental Illness | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-03-21 |
| 1861739682 | Jordan Marina Lilley | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1194062919 | Heather Marie Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1366799850 | Yuri Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-08-14 |
| 1992067359 | Soohyun Andrew Lee | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-06-12 |
| 1184984346 | Destiny Robin Topolski | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1477813574 | Amber Rae Stensen | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1457619231 | Tiffany Christine Brooks | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-30 |
| 1073871414 | Justin Won-sun Hwang | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851911036 | Michelle Renee Gilham | Massage Therapist | 16560 S.e. 80th Ave, Portland Or 97267, 19650 Se 80th Ave, Portland, OR 97267 | 2020-04-17 |
| 1629557442 | Benchmark Physical Therapy of Or, LLC | Occupational Therapist | 14874 Se Webster Rd, Milwaukie, OR 97267 | 2018-08-13 |
| 1326541764 | Theresa Elaine Day | Massage Therapist | 2080 Se Oak Grove Blvd Ste 16, Portland, OR 97267 | 2018-03-12 |
| 1881015378 | Kathryn Louise Engstrom | Registered Nurse | 6901 Se Lake Road, Portland, OR 97267 | 2013-12-30 |
| 1285951293 | Eliza Ann Rowley | Acupuncturist | 2080 Se Oak Grove Blvd #9, Milwaukie, OR 97267 | 2010-04-29 |
| 1346438124 | Rx Direct Inc | Pharmacy | 16246 Se Mcloughlin, Milwaukie, OR 97267 | 2007-10-05 |
| 1477740827 | Olson Drug, Inc | Durable Medical Equipment & Medical Supplies | 16244 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2007-10-01 |
| 1831308451 | Jeannie Marie Baer | Massage Therapist | 16705 Se Mcloughlin, Milwaukie, OR 97267 | 2007-05-21 |
| 1902923667 | Matthew William Krueger | Specialist/Technologist | 4950 Se Roethe Rd., Milwaukie, OR 97267 | 2007-03-26 |
| 1316084049 | Renee' Lorena Raschke | Counselor | 17070se Mcloughlin Blvd., Milwaukie, OR 97267 | 2007-01-31 |
| Find all providers in zip 97267 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275665572 | Justin Kimball | Adult Companion | 12408 Se Fuller Rd, Milwaukie, OR 97222-1245 | 2007-03-12 |
| 1861739682 | Jordan Marina Lilley | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1194062919 | Heather Marie Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1366799850 | Yuri Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-08-14 |
| 1992067359 | Soohyun Andrew Lee | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-06-12 |
| 1184984346 | Destiny Robin Topolski | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1477813574 | Amber Rae Stensen | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1457619231 | Tiffany Christine Brooks | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-30 |
| 1073871414 | Justin Won-sun Hwang | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-23 |
| 1083941249 | Shannon Thorpe | Adult Companion | 17070 Se Mcloughlin Blvd, Milwaukie, OR 97267-4960 | 2009-11-09 |
| Find all providers in MILWAUKIE | ||||
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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.