MR. WILLIAM OLLENBROOK (NPI# 1669688636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669688636 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM OLLENBROOK |
| Credential | LD |
| Practice Address |
3131 Se 122nd Ave Portland OR 97236-3209 |
| Practice Telephone | 5037611575 |
| Mailing Telephone | 5037611575 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | DTDO887304 | OR | Dental Providers |
| Street Address |
3131 SE 122ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-3209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841642287 | Veronika Buliga | Denturist | 6842 Se 66th Ave, Portland, OR 97206-7449 | 2016-07-11 |
| 1528435237 | Lidiya Bogdan | Denturist | 4637 Se 128th Ave, Portland, OR 97236-3713 | 2015-08-28 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1043595903 | Edward Espinoza Jr. | Denturist | 206 Ne 80th Ave, Portland, OR 97213-7016 | 2011-10-11 |
| 1629308648 | Theodore Keith Dhein | Denturist | 8064 S.e. Harold St., Portland, OR 97206-5148 | 2010-01-14 |
| 1417287244 | Kelly Carbone | Denturist | 980 Forest Ave Ste 104, Portland, ME 04103-3357 | 2009-12-29 |
| 1427298579 | Donald Marvin Lorenzen | Denturist | 8530 N. Ivanhoe, Portland, OR 97203 | 2009-03-03 |
| 1952551848 | Edward Jerrold Cooper Sr. | Denturist | 4645 South East 85th Ave., Portland, OR 97266 | 2008-09-26 |
| 1558577007 | Eui Young Suk | Denturist | 9234 Ne Glisan St, Portland, OR 97220-4532 | 2007-05-14 |
| 1568529998 | James Clifton Garbarino | Denturist | 1933 Sw Jefferson, Willamette Dental Gr, Portland, OR 97224 | 2007-01-03 |
| 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.