SEAN TYLER WATTERS


Address: 5050 Ne Hoyt St Ste 651, Portland, OR 97213
Phone: 5039358700

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
OR 500704186 05
WA 2028353 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
3181 Sw Sam Jackson Park Rd, Portland, OR 972393011 5034948211

Office Location

Street Address 5050 NE HOYT ST STE 651
City PORTLAND
State OR
Zip Code 97213

Providers in the same zip code

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 Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City PORTLAND
Zip Code 97213

Improve Information

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Dataset Information

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.

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