NORTHWEST ORAL PATHOLOGY (NPI# 1790229888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790229888 |
| Entity Type | Organization |
| Organization Name | NORTHWEST ORAL PATHOLOGY |
| Practice Address |
12254 Sw Garden Pl Tigard OR 97223-8246 |
| Mailing Address |
Po Box 230457 Tigard OR 97281-0457 |
| Practice Telephone | 5039067300 |
| Practice Fax Number | 5032458219 |
| Mailing Telephone | 5039067300 |
| Mailing Fax Number | 5032458219 |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |
| Authorized Official Name | FRANK JAMES KRATOCHVIL III (OWNER) |
| Authorized Official Telephone | 5039067300 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | NORTHWEST ORAL PATHOLOGY, LLC | 758 Cabana Lane, Lake Oswego, OR 97034 |
| Street Address |
12254 SW GARDEN PL |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-8246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487635371 | Jessica A Spies | Pathology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2005-11-08 |
| 1942513924 | Gabriel P Currie | Dermatology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2010-07-20 |
| 1659514958 | Andrea Lauer Chakrapani | Pathology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2009-04-16 |
| 1003940966 | Jessica Marie Ghaferi | Dermatology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2007-03-15 |
| 1861533481 | Curtis Thompson Md & Associates Pllc | Pathology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2007-02-08 |
| 1457408601 | Curtis Troy Thompson | Pathology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2007-01-03 |
| 1972564847 | Frank J Kratochvil IIi | Dentist | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2006-03-30 |
| 1780667527 | Stephanie J Mengden Koon | Dermatology | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2005-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093746174 | Southern Oregon Oral and Maxillofacial Surgeons | Dentist | 3162 State St, Medford, OR 97504-8450 | 2006-07-06 |
| 1669435806 | Bryan R. Harvey | Dentist | 331 Warner Milne Rd, Oregon City, OR 97045-4045 | 2006-04-10 |
| 1508827478 | Wei-yuhg Yih | Dentist | 611 Sw Campus Dr, Sd-515, Portland, OR 97239-3001 | 2006-03-30 |
| 1629286273 | Northwest Oral & Maxillofacial Surgeons, LLC | Dentist | 24850 Se Stark St, Suite 100, Gresham, OR 97030-8316 | 2007-05-18 |
| 1720044126 | Keith Edward Krueger | Dentist | 1475 Sw Chandler Ave, Suite 101, Bend, OR 97702-3238 | 2006-04-25 |
| 1063413722 | Henry Cooke Windell | Dentist | 24850 Se Stark St, Gresham, OR 97030-8316 | 2005-08-03 |
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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.