PACIFIC SPINE SPECIALISTS, LLC (NPI# 1740311679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740311679 |
| Entity Type | Organization |
| Organization Name | PACIFIC SPINE SPECIALISTS, LLC |
| Practice Address |
19260 Sw 65th Ave Ste 270 Tualatin OR 97062-5705 |
| Practice Telephone | 5038859391 |
| Practice Fax Number | 5037830909 |
| Mailing Telephone | 5038859391 |
| Mailing Fax Number | 5037830909 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | MS. FAYE L KAISER (BOOKKEEPER) |
| Authorized Official Telephone | 5037830201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD15842 | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 241875 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC SPINE SPECIALISTS, LLC | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062 |
| Street Address |
19260 SW 65TH AVE STE 270 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-5705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639160369 | Tana Marie Haynes | Internal Medicine | 19260 Sw 65th Ave Ste 270, Suite B2, Tualatin, OR 97062-5705 | 2005-11-02 |
| 1194343640 | Emily Ann Geyen | Physician Assistant | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2020-07-10 |
| 1932232741 | Northwest Internal Medicine LLC | Specialist | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2007-03-13 |
| 1194716571 | Timothy Lynn Keenen | Orthopaedic Surgery | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062 | 2005-11-03 |
| 1003807884 | Lisa Mae Cowan | Physician Assistant | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861870669 | Dlh Occupational Therapy, LLC | Specialist | 8050 Sw Warm Springs St Ste 130, Tualatin, OR 97062-7401 | 2015-05-12 |
| 1083001358 | Chelsea Washington | Specialist | 5649 Sw Lee St, Tualatin, OR 97062-6867 | 2015-04-23 |
| 1689943961 | Carey Baudino | Specialist | 18676 Sw Boones Ferry Rd, Tualatin, OR 97062-8435 | 2011-12-15 |
| 1922238773 | Marissa Miller Shaylor | Specialist | 19365 Sw 65th Ave Ste 104, Tualatin, OR 97062-9196 | 2009-07-14 |
| 1801069539 | Willamette Hematology-oncology PC | Specialist | 6464 Sw Borland Rd Ste B6, Tualatin, OR 97062-8876 | 2008-04-02 |
| 1902968373 | C. Edward Skeeters,m.d. & Michael P. Gardner,m.d. | Specialist | 19250 Sw 65th Ave Ste 235, Tualatin, OR 97062-7745 | 2006-12-14 |
| 1497746606 | Joanne Rudoff | Specialist | 6475 Sw Borland Rd, Suite L, Tualatin, OR 97062-9708 | 2005-11-04 |
| 1912906405 | Michael R Vanallen | Specialist | 19255 Sw 65th Ave, Suite 210, Tualatin, OR 97062-7451 | 2005-07-18 |
| 1417956020 | David Ming Fung Kao | Specialist | 6370 Sw Borland Rd Ste 200, Tualatin, OR 97062-9752 | 2005-07-15 |
| 1740285170 | James B Schader | Specialist | 19875 Sw 65th Ave, Suite 201, Tualatin, OR 97062-8353 | 2005-06-13 |
| Find all providers in TUALATIN | ||||
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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.