SEAN TYLER WATTERS (NPI# 1659714160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659714160 |
Entity Type | Individual |
Full Name | SEAN TYLER WATTERS |
Credential | M.D. |
Practice Address |
5050 Ne Hoyt St Ste 651 Portland OR 97213 |
Mailing Address |
847 Ne 19th Ave Ste 300 Portland OR 97232-2686 |
Practice Telephone | 5039358700 |
Practice Fax Number | 5039358701 |
Mailing Telephone | 5039632801 |
Mailing Fax Number | 5039632825 |
Enumeration Date | 2013-04-15 |
Last Update Date | 2018-08-31 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208600000X | Surgery | MD187475 | OR | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 500704186 | 05 | |
WA | 2028353 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
3181 Sw Sam Jackson Park Rd, Portland, OR 972393011 | 5034948211 |
Street Address |
5050 NE HOYT ST STE 651 |
City | PORTLAND |
State | OR |
Zip Code | 97213 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
Find all providers in zip 97213 |
Taxonomy Code | 208600000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386168029 | Northwest Minimally Invasive Surgery, LLC | Surgery | 2222 Nw Lovejoy St Ste 322, Portland, OR 97210-5101 | 2017-08-02 |
1366897399 | Andreas Hennig | Surgery | 783 Nw Naito Pkwy Apt 502, Portland, OR 97209-4755 | 2016-04-27 |
1871989467 | Cameron Cangelose | Surgery | 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239-3098 | 2015-04-09 |
1396157962 | Fernando Leon | Surgery | 2221 Sw First Ave Apt 2322, Portland, OR 97201-5023 | 2014-05-29 |
1114337466 | Thomas B Knowles | Surgery | 1130 Nw 22nd Ave Ste 500, Portland, OR 97210-2976 | 2014-05-07 |
1528301926 | Vincent A. Reger, Md PC | Surgery | 9155 Sw Barnes Rd Ste 406, Portland, OR 97225-6641 | 2013-04-03 |
1235496944 | Lori Cardwell | Surgery | Ohsu Gastrointestinal & General Surgery At Chh, 3303 Sw Bond Avenue, Portland, OR 97239-4501 | 2012-04-19 |
1053678284 | Tyler Scott Mittelstaedt | Surgery | 9200 Se 91st Ave Ste 320, Portland, OR 97086-3756 | 2012-04-12 |
1285990721 | John David Webber | Surgery | 12155 Sw Wildwood St, Portland, OR 97224-2919 | 2012-04-10 |
1912294422 | Lauren Marie Wancata | Surgery | 3181 Sw Sam Jackson Park Rd # 590, Portland, OR 97239 | 2011-07-05 |
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.