LYLE JAMES FAGNAN (NPI# 1669487161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669487161 |
| Entity Type | Individual |
| Full Name | LYLE JAMES FAGNAN |
| Credential | MD |
| Practice Address |
4411 Sw Vermont St Portland OR 97219-1020 |
| Mailing Address |
3181 Sw Sam Jackson Park Rd L222 Portland OR 97239-3011 |
| Practice Telephone | 5034949992 |
| Mailing Telephone | 5034941582 |
| Mailing Fax Number | 5034941513 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD10673 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 235119 | 05 |
| Street Address |
4411 SW VERMONT ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97219-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871558353 | Douglas Bruce Mckeag | Family Medicine | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2006-04-19 |
| 1013434646 | Sarah Kuppenbender Kong | Nurse Practitioner | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2017-08-24 |
| 1609396365 | Eric Wecker | Family Medicine | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2017-06-23 |
| 1164896791 | Jan Haxby | Pharmacist | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2015-11-19 |
| 1609289032 | Juliet F Baker | Specialist/Technologist | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2014-06-03 |
| 1417204041 | Sarah S Owens | Social Worker | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2012-08-14 |
| 1033466206 | University Professional Services | General Practice | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2012-08-07 |
| 1215282710 | Claire E. Hull | Physician Assistant | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2012-07-20 |
| 1699048686 | Pamela T English | Counselor | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2012-02-21 |
| 1346536018 | Ruth Christiansen | Physician Assistant | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2011-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639710783 | Christine Elizabeth O'connor | Family Medicine | 6336 Se 61st Ave, Portland, OR 97206-6718 | 2019-09-30 |
| 1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
| 1063064285 | Victoria A Deane | Family Medicine | 37 Fall Brook St, Portland, ME 04103-4224 | 2019-07-09 |
| 1598238214 | Whole Systems Healthcare | Family Medicine | 1020 Sw Taylor St Ste 340, Portland, OR 97205-2508 | 2019-01-04 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1871943159 | Micah Kiehl | Family Medicine | 4427 Ne Fremont St, Portland, OR 97213-1153 | 2016-06-16 |
| 1083068589 | Carrie Lynn Binder | Family Medicine | 1035 Nw Northrup St, Portland, OR 97209-3017 | 2016-04-20 |
| 1437513835 | Kayce A Spear | Family Medicine | 10803 Se Cherry Blossom Drive, Portland, OR 97216-3107 | 2016-04-12 |
| 1992175509 | Lone Star Evaluations Inc. | Family Medicine | 1500 Wildcat Dr Ste M, Portland, TX 78374-2826 | 2015-09-25 |
| 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.