MRS. HOLLY JEAN MCCORMICK (NPI# 1962668368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962668368 |
| Entity Type | Individual |
| Full Name | MRS. HOLLY JEAN MCCORMICK |
| Credential | EFDA |
| Practice Address |
17675 Sw Tualatin Valley Hwy Beaverton OR 97006-4443 |
| Mailing Address |
51468 Se Oak Grove Dr Scappoose OR 97056-4428 |
| Practice Telephone | 5032593169 |
| Mailing Telephone | 5033416316 |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2008-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | A5404 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225651698 | Holly Rachelle Mccormick | Behavior Technician | 20374 Spice Dr Apt C, Waynesville, MO 65583-3481 | 2020-05-20 |
| 1184757890 | Holly Herrin Mccormick | Pharmacist | 8445 Sw Highway 200, Ocala, FL 34481-9607 | 2007-03-13 |
| 1043254303 | Holly J Mccormick | Social Worker | 1019 E Water St, Elmira, NY 14901-3332 | 2006-06-16 |
| 1346291994 | Holly A Mccormick | Nurse Practitioner | 249 Main St, Cadiz, KY 42211-9154 | 2006-05-16 |
| Street Address |
17675 SW TUALATIN VALLEY HWY |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750300687 | Samuel Gottlieb | Dentist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2006-07-19 |
| 1487291043 | Jamie Lee Story | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-12-03 |
| 1700421583 | Francisca Yac Riscajche | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-11-15 |
| 1043751415 | Jesse Treanor | Dental Hygienist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2017-03-17 |
| 1578015855 | Kaiser Foundation Health Plan of The Northwest | Dentist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2016-11-02 |
| 1285180786 | Ann Archer | Dental Hygienist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2016-08-25 |
| 1639541816 | Samantha Forst | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2015-10-27 |
| 1588036818 | Christina Swayne | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2015-10-26 |
| 1164855896 | Bridget Madeline Lambert | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2013-08-16 |
| 1770915084 | Krista V Brandt | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2013-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821428483 | Austin Ruiz | Dental Assistant | 17715 Sw Robert Ln, Beaverton, OR 97007-1890 | 2013-11-19 |
| 1760493217 | Marzia Mohammady | Dental Assistant | 20628 Sw Celebrity Lane, Beaverton, OR 97007 | 2006-08-10 |
| 1275164360 | Tracey Alice Remington | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1245861343 | Rachelle Comedoy Encabo | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1295365559 | Rosa Gonzalez Albarado | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-24 |
| 1285264036 | Kelsey Tate | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-21 |
| 1043857105 | Reagan Ravanzo Blanco | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-12-06 |
| 1487291043 | Jamie Lee Story | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-12-03 |
| 1104462340 | Amanda Noelle Jenkins | Dental Assistant | 17675 Sw Tv Hwy, Beaverton, OR 97003-4443 | 2019-11-22 |
| 1144866591 | Asela Agtay Wells | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-11-20 |
| Find all providers in BEAVERTON | ||||
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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.