NORTHWEST NEURO-OPHTHALMOLOGY LLC (NPI# 1619345683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619345683 |
| Entity Type | Organization |
| Organization Name | NORTHWEST NEURO-OPHTHALMOLOGY LLC |
| Practice Address |
1585 Sw Marlow Ave Ste 110 Portland OR 97225-5176 |
| Practice Telephone | 5032911422 |
| Practice Fax Number | 5032978129 |
| Mailing Telephone | 5032911422 |
| Mailing Fax Number | 5032978129 |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-10-28 |
| Authorized Official Name | ROBERT EGAN (OWNER/MEMBER) |
| Authorized Official Telephone | 5032911422 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500693068 | 05 |
| Street Address |
1585 SW MARLOW AVE STE 110 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104826817 | Scott L. Strong | Dentist | 1585 Sw Marlow Ave, Suite 216, Portland, OR 97225-5176 | 2005-07-22 |
| 1750746004 | Nancy Borman, D.o., PC | Clinic/Center | 1585 Sw Marlow Ave, Site 200, Portland, OR 97225-5176 | 2015-12-30 |
| 1922487511 | Global Integrative Medical Solutions | Clinic/Center | 1585 Sw Marlow Ave, 200, Portland, OR 97225-5176 | 2015-05-28 |
| 1114319134 | Northwest Physical Therapy Care, LLC | Physical Therapist | 1585 Sw Marlow Ave, Portland, OR 97225-5176 | 2015-02-27 |
| 1245542752 | Natalia I Makarova | Dentist | 1585 Sw Marlow Ave, Ste 120, Portland, OR 97225-5176 | 2010-07-13 |
| 1013106681 | Stephen Gordon Woodyard | Dentist | 1585 Sw Marlow Ave, Portland, OR 97225-5176 | 2007-10-19 |
| 1699977785 | Oregon Pulmonary Associates, P.C. | Internal Medicine | 1585 Sw Marlow Ave, Suite 101, Portland, OR 97225-5176 | 2007-06-01 |
| 1760502546 | Vonny Ngantung | Dentist | 1585 Sw Marlow Ave, Suite 120, Portland, OR 97225-5176 | 2007-03-29 |
| 1962522532 | Wendell King | Dentist | 1585 Sw Marlow Ave, Suite 120, Portland, OR 97225-5176 | 2007-03-29 |
| 1215092986 | Dianna Lynn Henson | Naturopath | 1585 Sw Marlow Ave, Suite 200, Portland, OR 97225-5176 | 2006-12-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750739132 | Neil William Douglas Thomas | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr131, Oregon Health and Science University, Portland, OR 97239 | 2016-05-26 |
| 1205283462 | Candice Kam | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr-131s, Portland, OR 97239 | 2016-05-18 |
| 1881937050 | Michael Saul Farris | Psychiatry & Neurology | Ohsu-3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2013-04-05 |
| 1831460377 | Dennis B Smith | Psychiatry & Neurology | 827 Nw 25th Ave, Portland, OR 97210-3808 | 2012-01-13 |
| 1184883381 | Michelle Hannah Cameron | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd # L226, Portland, OR 97239-3011 | 2008-06-03 |
| 1043484801 | Aimee Lucinda Pierce | Psychiatry & Neurology | 3303 Sw Bond Ave Ste 8, Portland, OR 97239-4501 | 2008-04-14 |
| 1083800106 | Alyson Maloy | Psychiatry & Neurology | 449 Forest Ave # 214, Portland, ME 04101-2029 | 2007-09-21 |
| 1164647061 | Matthew Michael Evans | Psychiatry & Neurology | 5050 Ne Hoyt St Ste 315, Portland, OR 97213-2982 | 2007-04-16 |
| 1477670255 | Vivek Unni | Psychiatry & Neurology | Chh, 3303 S.w. Bond Ave., Portland, OR 97239 | 2007-03-25 |
| 1780711135 | Holly Elaine Hinson | Psychiatry & Neurology | 3181 S.w. Sam Jackson Park Road, Cr-129, Portland, OR 97239 | 2007-02-27 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on NORTHWEST NEURO-OPHTHALMOLOGY 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.