TODD MICHAEL ROSBOROUGH (NPI# 1922089580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922089580 |
| Entity Type | Individual |
| Full Name | TODD MICHAEL ROSBOROUGH |
| Credential | PAC |
| Practice Address |
135 Ne 102nd Ave Portland OR 97220-4167 |
| Practice Telephone | 5032555388 |
| Practice Fax Number | 5032555085 |
| Mailing Telephone | 5032555388 |
| Mailing Fax Number | 5032555085 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00576 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WA LABOR INDUSTRIES | 0131007 | 01 |
| Street Address |
135 NE 102ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438274 | Laboratory Corporation of America | Clinical Medical Laboratory | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2020-08-20 |
| 1184246134 | Yakima Valley Farm Workers Clinic | Family Medicine | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2020-05-13 |
| 1720489297 | Trung Phu Chung | Physician Assistant | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2014-09-15 |
| 1417217894 | Rose City Medical LLC | Clinic/Center | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2012-05-20 |
| 1972872646 | Jennifer Jablin | Nurse Practitioner | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2011-12-23 |
| 1700017167 | Gay Wong | Nurse Practitioner | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2009-08-04 |
| 1700833217 | Vee S Yoong | Physician Assistant | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2006-05-28 |
| 1518941525 | Timothy J Treible Md PC | Orthopaedic Surgery | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2005-12-02 |
| 1669454997 | Timothy James Treible | Orthopaedic Surgery | 135 Ne 102nd Ave, Portland, OR 97220-4167 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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.