Charissa Rose (NPI# 1114952355, PAC ID# 3072570977) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1114952355 |
| PAC ID by PECOS | 3072570977 |
| Professional Enrollment ID | I20041213000460 |
| Full Name | Charissa Rose |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Address |
12442 Sw Scholls Ferry Rd 206 Tigard OR 97223-0804 |
| Phone Number | 5032169200 |
| Gender | F |
| Credential | MD |
| Medical School | OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 0648183608 |
| Number of Group Practice Members | 1163 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380004 | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 12442 Sw Scholls Ferry, Rd 206, Tigard, OR 97223-0804 | 5032169200 | PROVIDENCE HEALTH AND SERVICES OREGON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Physicians | 1491 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yeong Paul Park | Physical Therapy | Providence Health and Services Oregon | 1627 Woods Ct, Prov Gorg Spi/spo M, Hood River, OR 97031-2915 |
| Traci Ackron | Family Medicine | Providence Health and Services Oregon | 909 Sw 18th Ave, Prov Med Gr Spor Car, Portland, OR 97205-1705 |
| Tierney Newman | Nurse Practitioner | Providence Health and Services Oregon | 4004 Kruse Way Pl, Suite 300, Lake Oswego, OR 97035-2479 |
| Angie R Cronin | Psychologist, Clinical | Providence Health and Services Oregon | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 |
| Jennifer N Herr | Nurse Practitioner | Providence Health and Services Oregon | 4805 Ne Glisan, Portland, OR 97213-2933 |
| Jaecelle Guadiz Galeniece | Family Medicine | Providence Health and Services Oregon | 1003 Providence Dr, Suite 325, Newberg, OR 97132-7521 |
| Amelia H Baker | Family Medicine | Providence Health and Services Oregon | 4920 N Interstate Ave, Portland, OR 97217-3653 |
| Sandra Iloka | Family Medicine | Providence Health and Services Oregon | 16770 Sw Edy Rd, 102 Pmg Sherwood Imed Cr, Sherwood, OR 97140-9679 |
| Duy Quang Tran | Family Medicine | Providence Health and Services Oregon | 839 Ne Holladay St, Portland, OR 97232-3521 |
| Steven Vorenkamp | Orthopedic Surgery | Providence Health and Services Oregon | 814 13th St, Hood River, OR 97031-1210 |
| Street Address |
12442 SW SCHOLLS FERRY RD 206 |
| City | TIGARD |
| State | OR |
| Zip | 97223-0804 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Evagelia Baros | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Yvonne Howell | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Raghuveer B Shenoy | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kathryn Marie Lund | Nurse Practitioner | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kevin A Brooks | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kirsten A Holmes | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Erin Michelle Helton | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Steven P Mcnally | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Mary A Thomason | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Melissa Peng | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Quincy Michael Shorthill | Physical Therapy | 8915 Swnordic Dr, Tigard, OR 97223 | |
| Robert L Marrs | Clinical Social Worker | 7175 Sw Beveland St, Suite 200, Tigard, OR 97223 | |
| Halsy J Carter | Chiropractic | 12700 Sw N Dakota St, 180 Straight Up Chiropractic, Tigard, OR 97223-0802 | |
| Heidi U Ferguson | Family Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-0803 |
| Jacob E Helton | Psychologist, Clinical | Providence Health and Services Oregon | 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-0803 |
| Mary E Kuebrich | Nurse Practitioner | Providence Health and Services Oregon | 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-0803 |
| Lesley K Segal | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Ranjana S Nathan | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Rebecca Marie Fort | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Sarah E Reed | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Find all physicians in zip 97223 | |||
| City | TIGARD |
| Zip Code | 97223 |
| Specialty | PSYCHIATRY |
| City + Specialty | TIGARD + PSYCHIATRY |
Please comment or provide details below to improve the information on Charissa Rose.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.