ELIAS DICKERMAN (NPI# 1881679728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881679728 |
| Entity Type | Individual |
| Full Name | ELIAS DICKERMAN |
| Credential | M.D., PH.D. |
| Practice Address |
6900 Sw Atlanta St Building 2, Suite 120 Portland OR 97223-2513 |
| Mailing Address |
Post Office Box 61745 Vancouver WA 98666 |
| Practice Telephone | 5036843988 |
| Mailing Telephone | 3607182967 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2015-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
CAG44614 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
OR12387 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
6900 SW ATLANTA ST BUILDING 2, SUITE 120 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97223-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194060210 | George Mcneill | Orthopaedic Surgery | 6900 Sw Atlanta St, Bldg 2, Suite 120, Portland, OR 97223-2513 | 2012-11-29 |
| 1144507195 | Mary Elizabeth Fisher | Counselor | 6900 Sw Atlanta St, Building 2, Suite 102, Portland, OR 97223-2513 | 2011-11-04 |
| 1518195742 | Oregon Medical Evaluations, Inc. | Case Management | 6900 Sw Atlanta St, Bldg. 2, Suite 120, Portland, OR 97223-2513 | 2009-06-25 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750739132 | Neil William Douglas Thomas | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr131, Oregon Health and Science University, Portland, OR 97239 | 2016-05-26 |
| 1205283462 | Candice Kam | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Road, Cr-131s, Portland, OR 97239 | 2016-05-18 |
| 1881937050 | Michael Saul Farris | Psychiatry & Neurology | Ohsu-3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2013-04-05 |
| 1831460377 | Dennis B Smith | Psychiatry & Neurology | 827 Nw 25th Ave, Portland, OR 97210-3808 | 2012-01-13 |
| 1184883381 | Michelle Hannah Cameron | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd # L226, Portland, OR 97239-3011 | 2008-06-03 |
| 1043484801 | Aimee Lucinda Pierce | Psychiatry & Neurology | 3303 Sw Bond Ave Ste 8, Portland, OR 97239-4501 | 2008-04-14 |
| 1083800106 | Alyson Maloy | Psychiatry & Neurology | 449 Forest Ave # 214, Portland, ME 04101-2029 | 2007-09-21 |
| 1164647061 | Matthew Michael Evans | Psychiatry & Neurology | 5050 Ne Hoyt St Ste 315, Portland, OR 97213-2982 | 2007-04-16 |
| 1477670255 | Vivek Unni | Psychiatry & Neurology | Chh, 3303 S.w. Bond Ave., Portland, OR 97239 | 2007-03-25 |
| 1780711135 | Holly Elaine Hinson | Psychiatry & Neurology | 3181 S.w. Sam Jackson Park Road, Cr-129, Portland, OR 97239 | 2007-02-27 |
| 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.