SHAYNE MAHEALANI AHWAH (NPI# 1790273811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790273811 |
| Entity Type | Individual |
| Full Name | SHAYNE MAHEALANI AHWAH |
| Credential | PAC |
| Practice Address |
9155 Sw Barnes Rd Ste 440 Portland OR 97225 |
| Mailing Address |
847 Ne 19th Ave Ste 300 Portland OR 97232-2686 |
| Practice Telephone | 5039358500 |
| Practice Fax Number | 5039358505 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-05-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA187846 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500742931 | 05 | |
| WA | 2099260 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5050 Ne Hoyt St Ste 359, Portland, OR 972132983 | 5039358501 | 5039358506 |
| Street Address |
9155 SW BARNES RD STE 440 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013161405 | Lorraine Walburga Gohman | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2008-11-11 |
| 1699373530 | Callie Chere' Peters | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2020-10-13 |
| 1871118091 | Courtney Jean Mostul | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2020-06-12 |
| 1376176073 | Krista Danielle Becker | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2020-02-20 |
| 1992296826 | Cody Craig Stekly | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2018-05-26 |
| 1336592468 | Amy Alberts | Nurse Practitioner | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2016-07-13 |
| 1851770945 | Travis Alexi Rabbit | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2015-05-22 |
| 1750780847 | Kareen Leavens | Obstetrics & Gynecology | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2014-08-14 |
| 1558700781 | Chad Esterberg | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2013-06-20 |
| 1437491115 | Teressa Elizabeth Haefele Raine | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225 | 2013-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1396250122 | Saron Theresa Sufuentes | Physician Assistant | 578 Nw Marlborough Ave, Portland, OR 97210-3104 | 2017-12-01 |
| 1952775520 | Lauren Govier | Physician Assistant | 501 N Graham St Ste 415, Portland, OR 97227-2006 | 2015-11-19 |
| 1619346368 | Ryan Mcmahon | Physician Assistant | 3415 Ne 20th Ave, Portland, OR 97212-2416 | 2015-09-23 |
| 1881090033 | Sanja Bukarac | Physician Assistant | 20 Buca Run, Portland, ME 04103-1427 | 2014-11-17 |
| 1194130716 | Nicole Lessard | Physician Assistant | 27 Bramhall St, Portland, ME 04102 | 2014-06-23 |
| 1528499910 | Elan Kennedy | Physician Assistant | 3181 Sw Sam Jackson Park Rd., Mail Code L353, Ohsu, Division of Cardiothoracic Surgery, Portland, OR 97239 | 2013-12-10 |
| 1013161405 | Lorraine Walburga Gohman | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2008-11-11 |
| 1841472065 | Mandy Melissa Williams | Physician Assistant | 265 N Broadway, Portland, OR 97227-1800 | 2007-11-29 |
| 1063612455 | Donald R Noel | Physician Assistant | 10101 Se Main St Ste 3008, Portland, OR 97216-2458 | 2007-07-23 |
| 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.